The cost-effectiveness of OS

Multiple studies have evaluated the cost-effectiveness of opportunistic salpingectomy (OS) during non-gynecological surgeries, using various models. (1,2) All studies demonstrate that OS is cost-effective compared to no OS. Our own cost-effectiveness analysis, based on mostly Dutch data, showed that OS during cholecystectomy and bariatric surgery resulted in a QALY gain of 0.033 and 0.034, and a cost reduction of €12 and €7 per patient, respectively. The probability that OS is cost-effective exceeded 99%. OS during nephrectomy for renal cell carcinoma or colectomy for colorectal cancer yielded a QALY gain of 0.012 and 0.016 and a cost increase of €39 and €25 per patient, respectively. The probability that OS is cost-effective was 94.2% and 96.6%. (3)

Kather et al. showed that OS during gynecological surgeries both saves costs and improves health outcomes, with an incremental cost-effectiveness ratio (ICER) of €−4,511.86 per quality-adjusted life year (QALY). (4) This study also demonstrated that if OS were performed during all eligible abdominal surgeries, including non-gynecological procedures, the ICER would improve even further to €−8,685.50/QALY. This means that adding OS to another surgery results in a cost reduction of €8,685.50 for every QALY gained.

References:

  1. Naumann RW, Hughes BN, Brown J, Drury LK, Herzog TJ. The impact of opportunistic salpingectomy on ovarian cancer mortality and healthcare costs: a call for universal insurance coverage. Am J Obstet Gynecol. 2021;225(4):397.e1-.e6.

  2. Matsuo K, Chen L, Matsuzaki S, Mandelbaum RS, Ciesielski KM, Silva JP, et al. Opportunistic Salpingectomy at the Time of Laparoscopic Cholecystectomy for Ovarian Cancer Prevention: A Cost-effectiveness Analysis. Ann Surg. 2023;277(5):e1116-e23.

  3. Schauwaert J, Bosman S, Fisch C et al Cost-Effectiveness of Opportunistic Salpingectomy During Various Nongynecological Abdominal Surgeries for the Prevention of Tubo-Ovarian Carcinoma: Results From a Markov Modeling StudyValue in Health, 2026; 0

  4. Kather A, Arefian H, Schneider C, Hartmann M, Runnebaum IB. Ovarian cancer prevention through opportunistic salpingectomy during abdominal surgeries: A cost-effectiveness modeling study. PLoS Med. 2025;22(1):e1004514.