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Cosmetic Tourism: A Cost-Utility Analysis Of Abdominoplasty Performed In The United States Versus Abroad
Morvarid Mehdizadeh, BA, Angelica Hernandez Alvarez, MD, Joshua Bloom, MD, Justin J. Cordero, BS, Iulianna Taritsa, BS, Daniela Lee, BS, Samuel J. Lin, MD, MBA.
Beth Israel Deaconess Medical Center, Boston, MA, USA.
PURPOSE: Rising U.S. abdominoplasty costs have driven patients to seek affordable options abroad despite risks. This study compares the cost-effectiveness of abdominoplasty performed in the U.S. versus abroad.
METHODS:Patients presenting to an academic hospital’s emergency department with complications from out-of-state/country abdominoplasties (2018-2022) were surveyed electronically. Utility scores were obtained from the survey and used to calculate quality adjusted life years (QALYs) for each health state. A literature review was performed to obtain the probabilities and outcomes for abdominoplasty performed in the U.S. versus abroad. A decision analysis tree was constructed with rollback analysis to determine the more cost-effective strategy. An Incremental Cost-Utility Ratio (ICUR) was calculated with willingness-to-pay of $100,000/QALY. Deterministic and probabilistic sensitivity analyses were performed.
RESULTS:Cosmetic tourism abdominoplasty was associated with a lower clinical effectiveness (39.08) compared to abdominoplasty in the U.S. (39.09), and a relative cost decrease of $2,066.26. The ICUR of $811,471.83/QALY did not result in cosmetic tourism abdominoplasty being cost-effective. In the case that the cost of the cosmetic tourism abdominoplasty was below $7,061.63, one-way sensitivity analyses showed this option was more cost-effective than abdominoplasty in the U.S., with 68.03% Monte-Carlo confidence.
CONCLUSION:Cosmetic tourism abdominoplasty is cost-effective only when priced below $7,061.63. This analysis may inform patients' reservation prices, considering postoperative complications, follow-up, and long-term relationships with healthcare providers.
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