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Facial Reconstruction Viewed As High-Value Intervention

Findings based on assessment of willingness to pay for correction of facial defects

woman face

MONDAY, March 28, 2016 (HealthDay News) -- Measuring willingness to pay per quality-adjusted life-year (WTP/QALY) provides a novel way to assess the social importance and value of facial reconstructive surgery, according to a study published online March 24 in JAMA Facial Plastic Surgery.

Jacob K. Dey, from the Johns Hopkins University School of Medicine in Baltimore, and colleagues measured society's perceived health state utility and dollar value for surgically reconstructing facial defects by questioning 200 observers of images of faces with defects of varying size and location before and after reconstructive surgery.

The researchers found that facial defects significantly decreased perceived health state utility, with the greatest penalty attributed to large and centrally located defects. For these large, centrally located facial defects, reconstruction did not increase health state utility to near-normal ranges. Participants reported willingness to pay an average of $1,170 to repair a de novo small peripheral defect, $4,274 more than the average to repair a large defect, and $2,372 more to repair a central defect. Thus, the WTP/QALY ranged from $639/QALY for repairing small peripheral defects to $2,838/QALY for repairing large central defects. This is well below all cost-effectiveness thresholds.

"To our knowledge, these are the first data demonstrating that surgical reconstruction of facial defects is a high-value intervention as perceived by society," the authors write. "These findings have implications for a broad range of stakeholders, including patients, surgeons, health policy makers, and payers."

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