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Loading of the upper eyelid (UELL) with gold weights (GWs) or platinum chains (PCs) is a highly effective procedure for the correction of lagophthalmos. Despite this, the procedure is used infrequently in our country because of the relatively high price of the implant and the lack of reimbursement. The aim of this research was to assess the factors influencing medical expenditures in this group of patients and to analyze utility costs for the UELL procedure with the use of GW and PC compared to tarsorrhaphy.<\/jats:p><jats:p><jats:bold>Material and methods<\/jats:bold> The costs of 88 surgical procedures (40 GWs, 11 PCs and 37 tarsorrhaphies) and medical expenditures before and after surgery were calculated based on reporting of materials, staff salaries and the SF-36 questionnaire. Distribution quartiles of the cost per QALY measure (dependent variable) was assessed via an ordered logistic regression model with eight explanatory variables.<\/jats:p><jats:p><jats:bold>Results<\/jats:bold> The calculated total cost of the surgery was US$209 for tarsorrhaphy, US$758 for UELL with a GW and US$1,676 for UELL with a PC. Bootstrapped costs per QALY values (CUI) in 88% of cases were below the US$100,000 cutoff. Etiology and duration of facial palsy and presence of Bell\u2019s phenomenon were factors that significantly influenced the CUI. Patient gender and age, history of previous eyelid surgery, and presence of corneal sensation were found to be not significant (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.1). Calculated ICER for GW was US$1,241.74\/1QALY and ICER for PC was US$13,181.05\/1QALY compared to tarsorrhaphy.<\/jats:p><jats:p><jats:bold>Conclusions<\/jats:bold> Eye protection in patients with FP should be a crucial element of health policy. Findings suggest UELL procedure with a GW or a PC to be a cost-effective procedure with GW being the most cost-effective.<\/jats:p>","DOI":"10.1186\/s13561-024-00506-6","type":"journal-article","created":{"date-parts":[[2024,4,27]],"date-time":"2024-04-27T08:02:37Z","timestamp":1714204957000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Factors influencing medical expenditures in patients with unresolved facial palsy and pharmacoeconomic analysis of upper eyelid lid loading with gold and platinum weights compared to tarsorrhaphy"],"prefix":"10.1186","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5251-2118","authenticated-orcid":false,"given":"Izabela","family":"Nowak-Gospodarowicz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcin","family":"Gospodarowicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marek","family":"R\u0119kas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,27]]},"reference":[{"issue":"7086","key":"506_CR1","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1136\/bmj.314.7086.991","volume":"314","author":"DA Mc Grounther","year":"1997","unstructured":"Mc Grounther DA. 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All patients provided written informed consent to participate in this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All participants of the study gave consent for publication of identifiable details, including photographs and case histories to be published with \u201copen access\u201d.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Izabela Nowak-Gospodarowicz, Marcin Gospodarowicz and Marek R\u0119kas declare that they have no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"30"}}