Randomised Comparison of Costs and Cost-Effectiveness of Cryostripping and Endovenous Laser Ablation for Varicose Veins
| Autor: | J.C. Kelder, Erik Buskens, D.J. der Kinderen, B.C.V.M. Disselhoff, F.L. Moll |
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| Přispěvatelé: | Science in Healthy Ageing & healthcaRE (SHARE), Methods in Medicines evaluation & Outcomes research (M2O) |
| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty SAPHENOUS-VEIN Cost effectiveness Cost-Benefit Analysis Cryosurgery DISEASE law.invention Varicose Veins Young Adult Randomized controlled trial law Policy decision Sclerotherapy Varicose veins Costs and cost-effectiveness Humans Medicine Saphenous Vein In patient health care economics and organizations Aged Netherlands Endovenous laser Medicine(all) Laser ablation business.industry Middle Aged Surgery Clinical trial LONG Cryostripping Ambulatory Surgical Procedures Physical therapy Female TRIAL Laser Therapy Quality-Adjusted Life Years medicine.symptom business Cardiology and Cardiovascular Medicine After treatment |
| Zdroj: | European Journal of Vascular and Endovascular Surgery, 37(3), 357-363. W B SAUNDERS CO LTD |
| ISSN: | 1078-5884 |
| DOI: | 10.1016/j.ejvs.2008.11.013 |
| Popis: | Background: Although endovenous laser ablation for varicose veins is replacing surgical stripping, proper economic evaluation with adequate follow-up in a randomised clinical trial is important for considered policy decisions regarding the implementation of new techniques.Methods: Data from a randomised controlled trial comparing cryostripping and endovenous laser ablation in 120 patients were combined to study Short Form (SF) 6D outcome, costs and cost-effectiveness 2 years after treatment. Incremental cost per quality-adjusted life year (QALY) gained 2 years after treatment was calculated using different strategies, and uncertainty was assessed with bootstrapping.Results: Over the total study period, mean SF-6D scores improved slightly from 0.78 at baseline to 0.80 at 2 years for patients who underwent cryostripping and from 0.77 to 0.79 for patients who underwent endovenous laser. QALY (SF-6D) was 1.59 in patients who underwent cryostripping and 1.60 in patients who underwent endovenous laser 2 years after treatment. The costs of cryostripping and endovenous laser per patient were (sic)2651 and (sic)2783, respectively. Bootstrapping indicated that cryostripping was associated with an incremental cost-effectiveness ratio of (sic)32 per QALY gained. With regard to different strategies, outpatient cryostripping was less costly and more effective 2 years after treatment.Conclusion: In this study, in terms of costs per QALY gained, outpatient cryostripping appeared to be the dominant strategy, but endovenous laser yielded comparable outcomes for a relatively little additional cost. (C) 2008 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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