Cost-effectiveness of endarterectomy in patients with asymptomatic carotid artery stenosis.
Br J Surg
; 95(6): 714-20, 2008 Jun.
Article
in En
| MEDLINE
| ID: mdl-18412295
ABSTRACT
BACKGROUND:
Long-term health outcomes and costs are important when deciding whether a strategy of carotid endarterectomy in addition to best medical management should be recommended for patients with asymptomatic carotid artery stenosis. This study investigated the cost-effectiveness of such a strategy compared with a strategy of best medical management alone.METHODS:
Based on data from the randomized Asymptomatic Carotid Surgery Trial (ACST), a national vascular database and other published sources, expected costs and health outcomes in terms of quality-adjusted life years (QALYs) of both treatment strategies were estimated using decision-analytical modelling. Cost-effectiveness was established for a Swedish setting from a societal perspective.RESULTS:
Base-case analysis showed that the incremental cost per QALY of a strategy with carotid endarterectomy for 65- and 75-year-old men (women) was 34,557 euros (311,133 euros) and 58,930 euros (779,776 euros) respectively. Sensitivity analyses indicated that the duration of the treatment effect after 5 years of follow-up in the ACST was important for the cost-effectiveness results.CONCLUSION:
Carotid endarterectomy in addition to best medical management can be considered cost-effective in men aged 73 years or less but is less likely to be cost-effective in older men or in women.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Endarterectomy, Carotid
/
Carotid Stenosis
Type of study:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Health_economic_evaluation
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspects:
Patient_preference
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
En
Journal:
Br J Surg
Year:
2008
Document type:
Article
Affiliation country: