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Cost-effectiveness of endovenous laser ablation of the great saphenous vein in patients with uncomplicated primary varicosis.

Luebke T, Brunkwall J - BMC Cardiovasc Disord (2015)

Bottom Line: Over the time horizon of 1-6 months, it was found that the incremental cost of EVLT compared with conventional surgery was €466.66 and the incremental effect was -0.007 QALY at 1 month, -0.0075 QALY at 3 months and 0.0 QALY at 6 months.This shows that the strategy "EVLT" was dominated by the strategy "HL/S" at any time point for the base cases analyses.The results of various alternative economic evaluations indicated that EVLT may be a potentially cost effective (i.e. incremental cost effectiveness ratio of between €12158.67 and €514721.67 per QALY, respectively) treatment option compared to conventional surgical treatment for varicose veins with a certainty between 54.9 and 98.8 %.

View Article: PubMed Central - PubMed

Affiliation: Department of Vascular and Endovascular Surgery, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germay. Thomas.luebke@uk-koeln.de.

ABSTRACT

Background: Although widely applied, the cost-effectiveness of endovenous laser ablation (EVLT) for varicose veins has not been established.

Methods: Cost-effectiveness analysis was performed on the evaluation of EVLT for the treatment of uncomplicated varicose veins by using published data from randomizd clinical trials regarding the costs and the quality of life. Incremental cost per quality-adjusted life year (QALY) gained at 6 months following treatment was calculated. Sensitivity analysis was carried out to investigate the uncertainty associated with the results of our analysis.

Results: Over the time horizon of 1-6 months, it was found that the incremental cost of EVLT compared with conventional surgery was €466.66 and the incremental effect was -0.007 QALY at 1 month, -0.0075 QALY at 3 months and 0.0 QALY at 6 months. This shows that the strategy "EVLT" was dominated by the strategy "HL/S" at any time point for the base cases analyses. The results of various alternative economic evaluations indicated that EVLT may be a potentially cost effective (i.e. incremental cost effectiveness ratio of between €12158.67 and €514721.67 per QALY, respectively) treatment option compared to conventional surgical treatment for varicose veins with a certainty between 54.9 and 98.8 %.

Conclusion: For patients with uncomplicated varicose veins and evidence of saphenofemoral reflux, surgical treatment for varicose veins offers a robust health benefit for relatively less costs compared to EVLT.

No MeSH data available.


Related in: MedlinePlus

a Alternative analysis 11: Cost-effectiveness acceptability curve. The graph gives the probability that HL/S (1 %) or EVLT (99 %) would be considered cost effective for a €50000 threshold of willingness to pay. b Monte Carlo simulation of EVLT vs. HL/S. A 10,000-iteration Monte Carlo simulation of a patient undergoing EVLT. The incremental cost and incremental effectiveness of EVLT compared with HL/S is plotted for each iteration. Of 10000.00 iterations, 9879.00 showed EVLT to be cost-effective by possessing ICERs below the €50,000/QALY threshold
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Fig4: a Alternative analysis 11: Cost-effectiveness acceptability curve. The graph gives the probability that HL/S (1 %) or EVLT (99 %) would be considered cost effective for a €50000 threshold of willingness to pay. b Monte Carlo simulation of EVLT vs. HL/S. A 10,000-iteration Monte Carlo simulation of a patient undergoing EVLT. The incremental cost and incremental effectiveness of EVLT compared with HL/S is plotted for each iteration. Of 10000.00 iterations, 9879.00 showed EVLT to be cost-effective by possessing ICERs below the €50,000/QALY threshold

Mentions: A number of alternative analyses of cost effectiveness were carried out to test assumptions made in the base case analyses and to improve the generalizability of the results, including using HUI2-II scores at different time points, using the VAS-derived SG scores as the measure of health outcome, and using alternative total costs for EVLT and HL/S (Tables 3, 4, 5, 6, 7; Fig. 4a, b; Fig. 5).Table 3


Cost-effectiveness of endovenous laser ablation of the great saphenous vein in patients with uncomplicated primary varicosis.

Luebke T, Brunkwall J - BMC Cardiovasc Disord (2015)

a Alternative analysis 11: Cost-effectiveness acceptability curve. The graph gives the probability that HL/S (1 %) or EVLT (99 %) would be considered cost effective for a €50000 threshold of willingness to pay. b Monte Carlo simulation of EVLT vs. HL/S. A 10,000-iteration Monte Carlo simulation of a patient undergoing EVLT. The incremental cost and incremental effectiveness of EVLT compared with HL/S is plotted for each iteration. Of 10000.00 iterations, 9879.00 showed EVLT to be cost-effective by possessing ICERs below the €50,000/QALY threshold
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4625802&req=5

Fig4: a Alternative analysis 11: Cost-effectiveness acceptability curve. The graph gives the probability that HL/S (1 %) or EVLT (99 %) would be considered cost effective for a €50000 threshold of willingness to pay. b Monte Carlo simulation of EVLT vs. HL/S. A 10,000-iteration Monte Carlo simulation of a patient undergoing EVLT. The incremental cost and incremental effectiveness of EVLT compared with HL/S is plotted for each iteration. Of 10000.00 iterations, 9879.00 showed EVLT to be cost-effective by possessing ICERs below the €50,000/QALY threshold
Mentions: A number of alternative analyses of cost effectiveness were carried out to test assumptions made in the base case analyses and to improve the generalizability of the results, including using HUI2-II scores at different time points, using the VAS-derived SG scores as the measure of health outcome, and using alternative total costs for EVLT and HL/S (Tables 3, 4, 5, 6, 7; Fig. 4a, b; Fig. 5).Table 3

Bottom Line: Over the time horizon of 1-6 months, it was found that the incremental cost of EVLT compared with conventional surgery was €466.66 and the incremental effect was -0.007 QALY at 1 month, -0.0075 QALY at 3 months and 0.0 QALY at 6 months.This shows that the strategy "EVLT" was dominated by the strategy "HL/S" at any time point for the base cases analyses.The results of various alternative economic evaluations indicated that EVLT may be a potentially cost effective (i.e. incremental cost effectiveness ratio of between €12158.67 and €514721.67 per QALY, respectively) treatment option compared to conventional surgical treatment for varicose veins with a certainty between 54.9 and 98.8 %.

View Article: PubMed Central - PubMed

Affiliation: Department of Vascular and Endovascular Surgery, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germay. Thomas.luebke@uk-koeln.de.

ABSTRACT

Background: Although widely applied, the cost-effectiveness of endovenous laser ablation (EVLT) for varicose veins has not been established.

Methods: Cost-effectiveness analysis was performed on the evaluation of EVLT for the treatment of uncomplicated varicose veins by using published data from randomizd clinical trials regarding the costs and the quality of life. Incremental cost per quality-adjusted life year (QALY) gained at 6 months following treatment was calculated. Sensitivity analysis was carried out to investigate the uncertainty associated with the results of our analysis.

Results: Over the time horizon of 1-6 months, it was found that the incremental cost of EVLT compared with conventional surgery was €466.66 and the incremental effect was -0.007 QALY at 1 month, -0.0075 QALY at 3 months and 0.0 QALY at 6 months. This shows that the strategy "EVLT" was dominated by the strategy "HL/S" at any time point for the base cases analyses. The results of various alternative economic evaluations indicated that EVLT may be a potentially cost effective (i.e. incremental cost effectiveness ratio of between €12158.67 and €514721.67 per QALY, respectively) treatment option compared to conventional surgical treatment for varicose veins with a certainty between 54.9 and 98.8 %.

Conclusion: For patients with uncomplicated varicose veins and evidence of saphenofemoral reflux, surgical treatment for varicose veins offers a robust health benefit for relatively less costs compared to EVLT.

No MeSH data available.


Related in: MedlinePlus