Cost-effectiveness analysis of the preparation of colonoscopy. Comparison between a PEG-electrolyte solution and a standard preparation

PEG-electrolyte solution has been considered the method of choice for preparation to colonoscopy, but no data about cost-effectiveness have been available so far. A controlled study enrolling 722 patients has been carried out in order to compare the cost-effectiveness of PEG-electrolyte solution and a traditional method consisting of low-residue diet, sennosides, magnesium sulphate and sodium phosphate enemas for preparation to colonoscopy. As primary measure, the proportion of patients submitted to repeated colonoscopy due to insufficient bowel cleansing PEG-electrolyte solution has been used. This was significantly lower after PEG-electrolyte solution (2%) than after traditional method (9%). Direct costs, reported per 100 cases, were lower with PEG-electrolyte solution (L. 20.655.000) than with traditional preparation (L. 21.746.000) with a saving of 5%. As far as total costs (direct plus indirect) are concerned the economical savings associated with use of PEG-electrolyte solution were L. 9.684.000 (21.5%). PEG-electrolyte solution appears more cost-effective than a traditional method for preparation to colonoscopy; therefore its use is also motivated by substantial economical benefits for the National Health System.