Cost-effectiveness of biodegradable pancreatic stents in post-ERCP pancreatitis prophylaxis

Abstract

Background Biodegradable biliopancreatic stents (BDS) are commercially available alternatives to conventional stents. While these offer potential economic benefits—such as eliminating the need for follow-up imaging or endoscopic procedures to retrieve retained stents—they have not been evaluated in a cost-effectiveness model. We aimed to develop a health economic model comparing conventional pancreatic stents (PS) with BDS for the prophylaxis of post-ERCP pancreatitis (PEP). Methods Data on pancreatic stents used for PEP and follow-up outcomes were extracted from the endoscopy database at The Royal Wolverhampton NHS Trust, United Kingdom, to develop a cost-benefit decision analysis model. Healthcare-associated quality of life data were sourced from the literature to derive utility values for the model. Complications related to retained stents were incorporated. Deterministic and probabilistic sensitivity analyses were performed. Incremental cost-effectiveness ratios (ICERs) were calculated using a willingness-to-pay (WTP) threshold of £30,000. Results Deterministic analysis demonstrated that using BDS for PEP prophylaxis was cost-effective compared to conventional PS (£656.12, 0.98 QALY for BDS vs. £377.59, 0.95 QALY for PS), yielding an ICER of £9316.70. Probabilistic sensitivity analysis similarly confirmed the cost-effectiveness of BDS over PS, with BDS being cost-effective at £666.67 for 0.98 QALY versus £373.68 for 0.95 QALY for PS. Threshold analysis identified a cost threshold of £353.37 for BDS to remain cost-effective. Conclusion BDS for PEP prophylaxis is cost effective compared to conventional PS, avoiding the need for follow-up imaging and repeat procedures for stent removal.