Pancreatic-stent placement for prevention of post-ERCP pancreatitis: a cost-effectiveness analysis.
Gastrointest Endosc
; 65(7): 960-8, 2007 Jun.
Article
em En
| MEDLINE
| ID: mdl-17331513
ABSTRACT
BACKGROUND:
Controlled trials support pancreatic-stent placement as an effective intervention for the prevention of post-ERCP acute pancreatitis in high-risk patients.OBJECTIVE:
To perform a decision analysis to evaluate the most cost-effective strategy for preventing post-ERCP pancreatitis.DESIGN:
Cost-effectiveness analysis.SETTING:
Patients undergoing ERCP.INTERVENTIONS:
Three competing strategies were evaluated in a decision analysis model from a third-party-payer perspective in hypothetical patients undergoing ERCP. In strategy I, none of the patients had pancreatic-stent placement. Strategy II had only those patients identified to be at high risk for post-ERCP, and, in strategy III, all patients underwent prophylactic stent placement. Probabilities of developing post-ERCP pancreatitis and the risk reduction by placement of a pancreatic stent were obtained from published information. Cost estimates were obtained from Medicare reimbursement rates. MAIN OUTCOME MEASUREMENTS Incremental cost-effectiveness ratio (ICER) of different strategies.RESULTS:
Strategy I was the least-expensive strategy but yielded the least number of life years. Strategy II yielded the highest number of years of life, with an ICER of $11,766 per year of life saved, and strategy III was dominated by strategy II.LIMITATIONS:
Indirect costs and pharmacologic prophylaxis were not considered in this analysis.CONCLUSIONS:
Pancreatic-stent placement for the prevention of post-ERCP pancreatitis in high-risk patients is a cost-effective strategy.
Buscar no Google
Base de dados:
MEDLINE
Assunto principal:
Ductos Pancreáticos
/
Pancreatite
/
Stents
/
Colangiopancreatografia Retrógrada Endoscópica
/
Implantação de Prótese
Idioma:
En
Ano de publicação:
2007
Tipo de documento:
Article