Figures (1)  Tables (4)

    • Figure 1. 

      Per patient costs over 12 months. ERCP, endoscopic retrograde cholangiopancreatography; DC, direct costs; IC, indirect costs.

    • Cost item Cost value, EGP
      Visit (gastroenterology) 150
      Consultation (gastroenterology) 300
      Total cost for an ERCP procedure with plastic stent application 7, 000
      Total cost for an ERCP procedure with metal stent application 14, 000
      Hospitalization for cholangitis 4, 224
      Average per diem cost for hospitalizations due to biliary re-obstruction 350
      Cost of time lost per day 75
      Values were rounded to the nearest integer in Egyptian pounds. ERCP, endoscopic retrograde cholangiopancreatography.

      Table 1. 

      Unit costs

    • Plastic stent group (n=45) Metal stent group (n=45) p value
      Total visits to gastroenterology 6.56(1.0) 2.77(0.4) 0.0001
      Total visits to consultants 7.2(2.1) 3.1(0.81) 0.0001
      Total ERCP procedures 3.6(1.1) 1.56(0.32) 0.0001
      Total days of hospitalization 5.7(1.8) 1.65(0.25) 0.0001
      Direct costs, EGP
          Visits to gastroenterology 882.2(167.3) 334.5(95.6) 0.0001
          Visits to consultants 1,000.1(241.6) 487.3(75.9) 0.0001
          All ERCP procedures 21,880(823.4) 14,189(634.2) 0.0001
          Lab investigations 3,378.2(329.5) 1,320.4(137.6) 0.0001
          Imaging 1,701.4(401.5) 653.2(217.5) 0.0001
          Medications 5,810.2(1,080.7) 2,360.3(732.6) 0.0001
          Follow-up 2,178.24(530.5) 845.12(198.4) 0.0001
          Hospitalization 4,027.5(1,165.7) 1,612.8(623.8) 0.0001
      Indirect costs, EGP 1,198.3(287.3) 600.1(87.4) 0.0001
          Absence from work 1,198.3 (287.3) 600.1 (87.4) 0.0001
      Data are presented as the mean (SD). Values were rounded to the nearest 2 decimals. The Student t test was used to assess significant differences in the cost of plastic and metal stents. Differences in both formulas are because each patient differed in number of hospitalizations. Therefore, to calculate the cost of hospitalization per patient we added the number of each patient's hospitalizations then divided it by the total number of patients who were hospitalized, then multiplied by the mean cost of each hospitalization. ERCP, endoscopic retrograde cholangiopancreatography.

      Table 2. 

      Medical resource utilization per patient

    • Patients with plastic stents Patients with plastic stents
      average cost per patient, EGP proportion of total direct/ indirect costs, % lower bound, EGP upper bound, EGP average cost per patient, EGP proportion of total direct/ indirect costs, % lower bound, EGP upper bound, EGP
      Directcosts Gastroenterology visits 882.2 2.16 240 880 334.5 1.53 110 330
      Consultant visits 1,000.10 2.45 300 875 487.3 2.24 135 450
      Investigations 3,378.20 8.27 1,000 3,000 1,320.40 6.06 450 1,200
      Imaging 1,701.40 4.16 520 1,550 653.2 2.99 220 600
      ERCP procedure 21,880 53.55 7,500 21,000 14,189 65.08 4,750 14,000
      Medications 5,810.20 14.22 1,900 5,750 2,360.30 10.83 780 2,240
      Hospitalizations 4,027.50 9.86 1,230 3,890 1,612.80 7.39 575 1,580
      Follow-up 2,178.24 5.33 720 2,100 845.12 3.88 284 788
      Total direct costs 40,857.84 100 13,410 39,045 21,802.62 100 7,304 21,188
      Indirect costs Time spent on gastroenterology visits 260 29 120 350 95 21 50 150
      Time spent on ERCP procedures 284 32 130 330 140 31 60 230
      Time spent at hospital 124 14 50 180 61 13 30 100
      Time spent away from ADL 220 25 130 300 158 35 90 250
      Total indirect costs 888 100 430 1,160 454 100 230 730
      Total direct and indirect costs, EGP 41,745.84 13,840 40,205 22,256.62 7,534 21,918
      Values were rounded to the nearest integer. Low and high values are based on the lower (25%) and upper (75%) quartiles. ADL, activities of daily living; ERCP, endoscopic retrograde cholangiopancreatography.

      Table 3. 

      Total direct and indirect costs

    • Plastic stent group (n = 45) Metal stent group (n = 45) p value
      Total time spent for visits in gastroenterology 28.78 (8.72) 13.82 (4.6) 0.0001
      Total time spent to undergo ERCP 12.29 (4.1) 3.08 (1.0) 0.0001
      Total time spent at hospital 42.89 (9.72) 13.23 (4.8) 0.0001
      Total of additional time spent away from ADL1 16.37 (5.3) 5.42 (1.6) 0.0001
      Data are presented as the mean number of days (SD). Values were rounded to the nearest 2 decimals. The Mann-Whitney test was used to assess significant differences in the cost of plastic and metal stents. ADL, activities of daily living; ERCP, endoscopic retrograde cholangiopancreatography.
          1 Differences in the sum of all the days spent away from ADL for all patients/number of patients in both formulas arise because patients had variable numbers of events causing days away from ADL.

      Table 4. 

      Time lost in days per patient