Inderhaug Eivind, Schelp Carl-Henrik, Glambek Inge, Kristiansen Ivar S
Surgical Department, Haraldsplass Deaconess University Hospital, Bergen, Norway.
Volvat Ulriksdal, Bergen, Norway.
SAGE Open Med. 2018 Sep 24;6:2050312118801709. doi: 10.1177/2050312118801709. eCollection 2018.
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.
Cost-effectiveness analysis using decision tree modelling.
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.
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.
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.
本研究旨在从社会和医疗保健支付方的角度，评估挪威五种常见静脉曲张手术方法的成本效益。
采用决策树模型进行成本效益分析。
进行结构化文献检索，以评估五种方法的临床疗效和并发症发生率。还收集了与静脉曲张疾病相关的成本和健康相关生活质量的数据。在一个专家小组的帮助下，开发了一个结构化决策树。建立了一个为期1年的模型，并纳入了各种常见并发症。采用蒙特卡洛模拟进行概率敏感性分析。
从社会角度来看，[具体方法名称]策略是最具成本效益的选择，与不治疗的替代方案相比，增量成本效益比为8448欧元，使用挪威59880欧元的支付意愿阈值时，具有成本效益的概率为42%。然而，从医疗保健支付方的角度来看，[具体方法名称]策略是最具成本效益的，与不治疗的替代方案相比，增量成本效益比为4072欧元，该策略具有成本效益的概率为50%。
本研究的结果确实取决于所选择的分析角度。尽管最近的静脉内手术方法（包括[具体方法名称]和[具体方法名称]）为晚期有症状的静脉曲张疾病提供了临床有效的治疗方法，但高水平数据的可用性目前限制了成本效益分析。
