Objective: The aim of this work was to estimate cost-effectiveness of five common procedures for varicose vein surgery ( and ) in a Norwegian setting from both a societal and a healthcare payer perspective.
Design: Cost-effectiveness analysis using decision tree modelling.
Methods: A structured literature search was conducted to estimate the clinical effectiveness and the rate of complications in the five methods. Data on costs and health-related quality of life associated with varicose vein disease were also collected. With the aid of an expert panel, a structured decision tree was developed. A 1-year perspective was modelled, and a variety of common complications were included. Monte Carlo simulation was used for probabilistic sensitivity analyses.
Results: The strategy was the most cost-effective option from a societal perspective, with an incremental cost-effectiveness ratio of €8448 compared to a no-treatment alternative, and had a 42% probability of being cost-effective using the Norwegian willingness-to-pay threshold of €59,880. From a healthcare payer perspective, however, the strategy was the most cost-effective with an incremental cost-effectiveness ratio of €4072 compared to a no-treatment alternative, and this strategy had a 50% probability of being cost-effective.
Conclusion: Results from this study did depend upon the perspective chosen for analyses. Although recent endovenous surgical procedures (including and ) provide clinically effective treatment for advanced, symptomatic varicose vein disease, availability of high-level data is currently limiting the cost-effectiveness analyses.
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| http://dx.doi.org/10.1177/2050312118801709 | DOI Listing |
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