Health gains, costs and cost-effectiveness of a population-based screening programme for abdominal aortic aneurysms.
Br J Surg
; 106(8): 1043-1054, 2019 07.
Article
em En
| MEDLINE
| ID: mdl-31115915
ABSTRACT
BACKGROUND:
Abdominal aortic aneurysm (AAA) rupture carries a high fatality rate. AAAs can be detected before rupture by abdominal ultrasound imaging, allowing elective repair. Population-based screening for AAA in older men reduces AAA-related mortality by about 40 per cent. The UK began an AAA screening programme offering one-off scans to men aged 65 years in 2009. Sweden has a similar programme. Currently, there is no AAA screening programme in New Zealand. This cost-utility analysis aimed to assess the cost-effectiveness of a UK-style screening programme in the New Zealand setting.METHODS:
The analysis compared a formal AAA screening programme (one-off abdominal ultrasound imaging for about 20 000 men aged 65 years in 2011) with no systematic screening. A Markov macrosimulation model was adapted to estimate the health gains (in quality-adjusted life-years, QALYs), health system costs and cost-effectiveness in New Zealand. A health system perspective and lifetime horizon was adopted.RESULTS:
With New Zealand-specific inputs, the adapted model produced an estimate of about NZ $15 300 (7746) per QALY gained, with a 95 per cent uncertainty interval (UI) of NZ $8700 to 31 000 (4405 to 15 694) per QALY gained. Health gains were estimated at 117 (95 per cent UI 53 to 212) QALYs. Health system costs were NZ $1·68 million (850 535), with a 95 per cent UI of NZ $820 200 to 3·24 million (415 243 to 1·65 million).CONCLUSION:
Using New Zealand's gross domestic product per capita (about NZ $45 000 or 22 100) as a cost-effectiveness threshold, a UK-style AAA screening programme would be cost-effective in New Zealand.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Programas de Rastreamento
/
Aneurisma da Aorta Abdominal
Tipo de estudo:
Diagnostic_studies
/
Health_economic_evaluation
/
Prognostic_studies
/
Screening_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
País/Região como assunto:
Oceania
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article