Dushu Lake Hospital Affiliated to Soochow University, Soochow, China.
Northern Jiangsu People's Hospital, Yangzhou, China.
Clin Appl Thromb Hemost. 2021 Jan-Dec;27:10760296211061147. doi: 10.1177/10760296211061147.
AngioJet has sufficient safety and efficacy in the treatment of acute and subacute lower extremity deep vein thrombosis (LEDVT). But the price of consumables used by AngioJet is relatively high and there is a lack of relevant research on health economics to measure the benefits to patients. Objective of this study is to estimate the cost effectiveness of AngioJet compared with catheter-directed thrombolysis (CDT) among Chinese population. Using a Markov decision model, we compared the 2 treatment strategies in patients with LEDVT. The model captured the development of post-thrombotic syndrome (PTS), recurrent venous thromboembolism, and treatment-related adverse events within a lifetime horizon and the perspective of a third-party payer. Model uncertainty was assessed with one-way and Monte Carl sensitivity analyses. The clinical inputs were obtained from the literature. Costs obtained from the hospital accounts and the literature are expressed in US dollars ($). Utilities were defined as quality adjusted life years (QALY). In cost-effectiveness analysis, AngioJet accumulated $1064.6445/QALY compared with $2080.1561/QALY after CDT treatment alone. AngioJet has higher long-term cost-effectiveness than CDT at a willingness to pay threshold of $11 233.52. One-way sensitivity analysis showed that the utilities of PTS and post-LEDVT state had significant influence on the results and the model maintained a strong stability under ± 10% fluctuation of utilities. Monte Carl sensitivity analysis shows that AngioJet model has strong stability and AngioJet has higher long-term cost-effectiveness than CDT. AngioJet is likely to be a cost-effective alternative to the CDT for patients with LEDVT.
AngioJet 在治疗急性和亚急性下肢深静脉血栓形成（LEDVT）方面具有足够的安全性和疗效。但是，AngioJet 使用的耗材价格相对较高，并且缺乏关于卫生经济学的相关研究来衡量对患者的收益。本研究的目的是评估 AngioJet 与导管溶栓（CDT）在中国人群中的成本效益。我们使用马尔可夫决策模型比较了 LEDVT 患者的 2 种治疗策略。该模型在终生和第三方支付者的角度上捕获了血栓后综合征（PTS）、复发性静脉血栓栓塞和与治疗相关的不良事件的发展。通过单向和蒙特卡罗敏感性分析评估模型不确定性。临床输入来自文献。从医院账户和文献中获得的成本以美元（$）表示。效用被定义为质量调整生命年（QALY）。在成本效益分析中，与单独接受 CDT 治疗相比，AngioJet 每增加 1064.6445/QALY，而 AngioJet 每增加 1064.6445/QALY。在支付意愿阈值为 11233.52 美元时，AngioJet 具有更高的长期成本效益。单向敏感性分析表明，PTS 和 LEDVT 后状态的效用对结果有重大影响，并且在效用波动 10%的情况下，该模型保持了很强的稳定性。蒙特卡罗敏感性分析表明，AngioJet 模型具有很强的稳定性，并且 AngioJet 具有比 CDT 更高的长期成本效益。对于 LEDVT 患者，AngioJet 可能是 CDT 的一种具有成本效益的替代方案。
