uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Cost-effectiveness of Screening for Abdominal Aortic Aneurysm in Combination with Medical Intervention in Patients with Small Aneurysms
Skane Univ Hosp, Dept Vasc Dis, S-20502 Malmo, Sweden..
IHE, Swedish Inst Hlth Econ, Lund, Sweden..
Skane Univ Hosp, Dept Vasc Dis, S-20502 Malmo, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
Show others and affiliations
2016 (English)In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 51, no 6, 766-773 p.Article in journal (Refereed) PublishedText
Abstract [en]

Objectives: Screening for abdominal aortic aneurysm (AAA) among 65 year old men has been proven costeffective, but nowadays is conducted partly under new conditions. The prevalence of AAA has decreased, and endovascular aneurysm repair (EVAR) has become the predominant surgical method for AAA repair in many centers. At the Malmo Vascular Center pharmacological secondary prevention with statins, antiplatelet therapy, and blood pressure reduction is initiated and given to all patients with AAA. This study evaluates the costeffectiveness of AAA screening under the above mentioned conditions. Methods: This was a Markov cohort simulation. A total of 4,300 65 year old men were invited to annual AAA screening; the attendance rate was 78.3% and AAA prevalence was 1.8%. A Markov model with 11 health states was used to evaluate cost-effectiveness of AAA screening. Background data on rupture risks, costs, and effectiveness of surgical interventions were obtained from the participating unit, the national Swedvasc Registry, and from the scientific literature. Results: The additional costs of the screening strategy compared with no screening were 169 per person and year. The incremental health gain per subject in the screened cohort was 0.011 additional quality adjusted life years (QALYs), corresponding to an incremental cost-effectiveness ratio (ICER) of 15710 per QALY. Assuming a 10% reduction of all cause mortality, the incremental cost of screening was 175 per person and year. The gain per subject in the screened cohort was 0.013 additional QALYs, corresponding to an ICER of 13922 per QALY Conclusions: AAA screening remains cost-effective according to both the Swedish recommendations and the UK National Institute for Health and Care Excellence recommendations in the new era of lower AAA prevalence, EVAR as the predominant surgical method, and secondary prevention for all AAA patients.

Place, publisher, year, edition, pages
2016. Vol. 51, no 6, 766-773 p.
Keyword [en]
Abdominal aortic aneurysm, Markov, Screening
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-299902DOI: 10.1016/j.ejvs.2015.12.048ISI: 000378441700004PubMedID: 26952345OAI: oai:DiVA.org:uu-299902DiVA: diva2:950377
Available from: 2016-07-29 Created: 2016-07-29 Last updated: 2016-07-29Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Troeng, Thomas
By organisation
Vascular Surgery
In the same journal
European Journal of Vascular and Endovascular Surgery
Cardiac and Cardiovascular Systems

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 7 hits
ReferencesLink to record
Permanent link

Direct link