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'''per year''' seems too high

Posted by Farrel on 28 Nov 2012 at 23:36 GMT

tracheotomy rate of 11% per year

My understanding of the literature is that about 10% (or more recently <10%) of those with juvenile-onset recurrent respiratory papillomatosis undergo a tracheostomy. I do not believe it is 10% per year but rather 10% per lifetime. In adult-onset recurrent respiratory papillomatosis it would probably be lower than 10%.

No competing interests declared.

RE: Authors reply

GFavato1 replied to Farrel on 22 Feb 2013 at 11:51 GMT

No Italian data are currently available on the lifetime cost per patient affected by Respiratory Recurrent Papillomatosis (RRP). Our estimates were modelled on the basis of the few data published in the international literature (1). More specifically, the lifetime prevalence of tracheostomy in RRP patients was estimated in the range of 11-14%. The annual costs incurred by patients after tracheostomy were estimated to be $75,000 ± $15,000 per year over a 4.2 year time horizon.
In absence of Italian data, we chose a conservative approach to cost modelling. The lifetime prevalence of tracheostomy was set at 11% of the RRP patients, the lowest limit of the previously published range. Concerning the annualised costs, we estimated them to be equal to a single intervention of minor tracheostomic surgery or maintainance (DRG 75) per year over the 4.2 year time horizon. The annualised, inflation-adjusted cost of € 9,998 which was used to inform the model resulted significantly lower than the estimates published for the U.S.
The lack of local epidemiological and cost data represents one of the major limitations of our study, but it should not represent a major bias in the overall estimate of the economic burden of HPV-related diseases in Italy.

Prof. Giampiero Favato
Corresponding Author

1. Bishai D, Kashima H, Shah K (2000) The cost of juvenile-onset recurrent respiratory papillomatosis. Archives of Otolaryngology – Head and Neck Surgery 126: 935–939.

No competing interests declared.