| Cost-effectiveness of endarterectomy in patients with asymptomatic carotid artery stenosis. | |
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MedLine Citation:
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PMID: 18412295 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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M Henriksson; F Lundgren; P Carlsson |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The British journal of surgery Volume: 95 ISSN: 1365-2168 ISO Abbreviation: Br J Surg Publication Date: 2008 Jun |
Date Detail:
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Created Date: 2008-05-05 Completed Date: 2008-05-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372553 Medline TA: Br J Surg Country: England |
Other Details:
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Languages: eng Pagination: 714-20 Citation Subset: AIM; IM |
Copyright Information:
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2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. |
Affiliation:
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Centre for Medical Technology Assessment, Linköping University, Linköping, Sweden. martin.henriksson@ihs.liu.se |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Carotid Stenosis / economics, surgery* Cohort Studies Cost-Benefit Analysis Decision Support Techniques Endarterectomy, Carotid / economics* Female Humans Male Markov Chains Quality-Adjusted Life Years Sensitivity and Specificity Stroke / economics, prevention & control |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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