{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T21:19:05Z","timestamp":1769203145787,"version":"3.49.0"},"reference-count":20,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,1,4]],"date-time":"2018-01-04T00:00:00Z","timestamp":1515024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To evaluate the cost\u2010effectiveness of Floseal, a topically applied hemostatic agent, and nasal packing for the management of epistaxis in Canada.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Outcomes research, a cost\u2010utility analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We developed a Markov model to compare the costs and health outcomes of Floseal with nasal packing over a lifetime horizon from the perspective of a publicly funded healthcare system. A cycle length of 1 year was used. Efficacy of Floseal and packing was sought from the published literature. Unit costs were gathered from a hospital case costing system, whereas physician fees were extracted from the Ontario Schedule of Benefits for Physician Services. Results were expressed as an incremental cost per quality\u2010adjusted life year (QALY) gained. A series of one\u2010way sensitivity and probabilistic sensitivity analyses were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From the perspective of a publicly funded health are system, the Floseal treatment strategy was associated with higher costs ($2,067) and greater QALYs (0.27) than nasal packing. Our findings were highly sensitive to discount rates, the cost of Floseal, and the cost of nasal packing. The probabilistic sensitivity analysis suggested that the probability that Floseal treatment is cost\u2010effective reached 99% if the willingness\u2010to\u2010pay threshold was greater than $120,000 per QALY gained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Prior studies have demonstrated Floseal to be an effective treatment for anterior epistaxis. In the Canadian healthcare system, Floseal treatment appears to be a cost\u2010effective treatment option compared to nasal packing for anterior epistaxis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2c <jats:italic>Laryngoscope<\/jats:italic>, 1778\u20131782, 2018<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27081","type":"journal-article","created":{"date-parts":[[2018,1,4]],"date-time":"2018-01-04T08:32:29Z","timestamp":1515054749000},"page":"1778-1782","source":"Crossref","is-referenced-by-count":9,"title":["Economic evaluation of floseal compared to nasal packing for the management of anterior epistaxis"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1914-1447","authenticated-orcid":false,"given":"Andre","family":"Le","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kednapa","family":"Thavorn","sequence":"additional","affiliation":[{"name":"School of Epidemiology and Public Health University of Ottawa Ottawa Ontario Canada"},{"name":"Ottawa Hospital Research Institute Ottawa Ontario Canada"},{"name":"Institute for Clinical and Evaluative Sciences ICES@uOttawa Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Lasso","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaun J.","family":"Kilty","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,1,4]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2005.11.031"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2004.12.014"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e32814b06ed"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2482-14-111"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2016.0224"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-016-0138-2"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12070-011-0343-2"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLG.0000160528.50017.3C"},{"key":"e_1_2_6_10_1","unstructured":"The World Bank.Life expectancy at birth total (years). 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