212 posters, 10 topics, 5 sessions, 754 authors, 237 institutions

The AAPS 101st Annual Meeting

29 April – 2 May, 2023 | Chicago, IL

D96

The Cost-effectiveness Of Gender-affirming Mastectomy

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Poster Presenter

Brian Conway

Authors

Brian Conway, Alexandra Polovneff, Conner McMains, Emily McGinley, Lilana Pezzin, Kate Krucoff

Affiliations

Medical College of Wisconsin, Medical College of Wisconsin, Department of Plastic & Reconstructive Surgery, Medical College of Wisconsin, Center for Advancing Population Science, Medical College of Wisconsin, Department of Medicine, Institute for Health and Equity

Part of Topic

Gender Affirmation

Title: The Cost-Effectiveness of Gender-Affirming Mastectomy

Authors: Brian J Conway, BS (1); Alexandra O Polovneff, BS(1); Conner J McMains, MD(1,2); Emily McGinley, MS, MPH(1,3); Lilana E Pezzin, PhD(1,4), JD; Kate B. Krucoff, MD (1,2)

(1) Medical College of Wisconsin, Milwaukee, WI (2) Department of Plastic & Reconstructive Surgery (3) Center for Advancing Population Science (4) Department of Medicine, Institute for Health and Equity

Background:

•Mortality rates are higher in the transgender and gender diverse (TGD) community due in part to psychiatric comorbidity.

•Gender-affirming surgery and hormone therapy (GAS/GAHT) is associated with enhanced mental health and quality of life.

•Cost of care and systematic bias limit access to GAS/GAHT, which are potentially life-saving services.

•The purpose of this study was to demonstrate the short-term cost-effectiveness of gender-affirming mastectomy.

Methods:

•A cost-effectiveness study was performed using a Markov model and a willingness to pay (WTP) threshold of $50,000/Quality Adjusted Life Years (QALY’s).

•Health event data extracted from the 2015 US Transgender Survey (USTS) Report, the Froedtert & Medical College of Wisconsin Health Network, and literature.

•Incremental cost-effectiveness ratios (ICER’s) were calculated.

Conclusions and Future Directions:

•Gender-affirming mastectomy is cost-effective in the short-term with an ICER less than the WTP after two years suggesting gender-affirming care should be widely accessible.

•Future studies will determine the long-term cost-effectiveness of mastectomy.