A Cost-utility Analysis of Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm
| Autor: | Yutaka Takayama |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment extremely old age 030204 cardiovascular system & hematology Endovascular aneurysm repair law.invention endovascular aneurysm repair 03 medical and health sciences abdominal aortic aneurysm 0302 clinical medicine Randomized controlled trial law Medical economics incremental cost-effectiveness ratio Medicine In patient 030212 general & internal medicine Cost–utility analysis business.industry Open surgery cost-utility analysis General Medicine medicine.disease Abdominal aortic aneurysm Cancer registry Surgery Conservative treatment Original Article business Incremental cost-effectiveness ratio |
| Zdroj: | Annals of Vascular Diseases |
| ISSN: | 1880-8840 0387-1126 |
| DOI: | 10.7133/jca.16-00014 |
| Popis: | Objective: To assess medical economic adequacy of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). Methods: Cost-utility analysis. A total of 21 patients with AAA treated at Ibaraki Prefectural Central Hospital in 2014 were divided into non-ruptured EVAR (Group E) and open surgery (OS) (Group O), and ruptured OS (Group R) groups, and hospital costs were aggregated with a medical accounting system. Mid-level hospital costs were estimated by a diagnosis-procedure-combination analysis system. Incremental life years were extrapolated from the results of randomized controlled trials in the UK (EVAR Trial 1 and 2), a life table, and the Pancreas Cancer Registry in Japan. Quality-adjusted life years (QALY) were estimated under the assumption of a certain quality weight. Results: Incremental cost-effectiveness ratio (ICER) of EVAR compared with the OS was calculated to be 31.0 million yen/QALY, which is economically inadequate. ICER of EVAR compared with conservative treatment was inadequate in some subgroups of extremely old patients and in patients operated for far-advanced cancer. Conclusion: EVAR is inadequate with respect to medical economics as a substitute for OS for patients in whom both procedures are available. The indication for EVAR in patients ineligible for OS should be different from that for surgery in usual patients with AAA. (This is a translation of J Jpn Coll Angiol 2016; 56: 123-130.). |
| Databáze: | OpenAIRE |
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