Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
J Vasc Surg. 2012 Oct;56(4):901-9.e2. doi: 10.1016/j.jvs.2012.01.086. Epub 2012 May 27.

Cost-effectiveness of open versus endovascular repair of abdominal aortic aneurysm in the OVER trial.

Collaborators (317)

Ketteler ER, Kingsley DD, Marek JM, Massen RJ, Matteson BD, Pitcher J, Langsfeld M, Corson JD, Goff JM Jr, Kasirajan K, Paap C, Robertson DC, Salam A, Veeraswamy R, Milner R, Kasirajan K, Guidot J, Lal BK, Busuttil SJ, Lilly MP, Braganza M, Ellis K, Patterson MA, Jordan WD, Whitley D, Taylor S, Passman M, Kerns D, Inman C, Poirier J, Ebaugh J, Raffetto J, Chew D, Lathi S, Owens C, Hickson K, Dosluoglu HH, Eschberger K, Kibbe MR, Baraniewski HM, Matsumura J, Endo M, Busman A, Meadows W, Evans M, Giglia JS, El Sayed H, Reed AB, Ruf M, Ross S, Jean-Claude JM, Pinault G, Kang P, White N, Eiseman M, Jones R, Timaran CH, Modrall J, Welborn M 3rd, Lopez J, Nguyen T, Chacko JK, Granke K, Vouyouka AG, Olgren E, Chand P, Allende B, Ranella M, Yales C, Whitehill TA, Krupski WC, Nehler MR, Johnson SP, Jones DN, Strecker P, Bhola MA, Shortell CK, Gray JL, Lawson JH, McCann R, Sebastian MW, Tetterton JK, Blackwell C, Prinzo PA, Lee N, Padberg FT Jr, Cerveira JJ, Lal BK, Zickler RW, Hauck KA, Berceli SA, Lee W, Ozaki C, Nelson PR, Irwin AS, Baum R, Aulivola B, Rodriguez H, Littooy FN, Greisler H, O'Sullivan MT, Kougias P, Lin PH, Bush RL, Guinn G, Bechara C, Cagiannos C, Pillack S, Guillory B, Cikrit D, Lalka SG, Lemmon G, Nachreiner R, Rusomaroff M, O'Brien E, Cullen JJ, Hoballah J, Sharp W, McCandless JL, Beach V, Minion D, Schwarcz TH, Kimbrough J, Ashe L, Rockich A, Warner-Carpenter J, Moursi M, Eidt JF, Brock S, Bianchi C, Bishop V, Gordon IL, Fujitani R, Kubaska SM 3rd, Behdad M, Azadegan R, Agas CM, Zalecki K, Hoch JR, Carr SC, Acher C, Schwarze M, Tefera G, Mell M, Dunlap B, Rieder J, Stuart JM, Weiman DS, Abul-Khoudoud O, Garrett H, Walsh SM, Wilson KL, Seabrook GR, Cambria RA, Brown KR, Lewis BD, Framberg S, Kallio C, Barke RA, Santilli SM, d'Audiffret AC, Oberle N, Proebstle C, Johnson LL, Jacobowitz GR, Cayne N, Rockman C, Adelman M, Gagne P, Nalbandian M, Caropolo LJ, Pipinos II, Johanning J, Lynch T, DeSpiegelaere H, Purviance G, Zhou W, Dalman R, Lee JT, Safadi B, Coogan SM, Wren SM, Bahmani DD, Maples D, Thunen S, Golden M, Mitchell ME, Fairman R, Reinhardt S, Wilson MA, Tzeng E, Muluk S, Peterson NM, Foster M, Edwards J, Moneta GL, Landry G, Taylor L, Yeager R, Cannady E, Treiman G, Hatton-Ward S, Salabsky B, Kansal N, Owens E, Estes M, Forbes BA, Sobotta C, Rapp JH, Reilly LM, Perez SL, Yan K, Sarkar R, Dwyer SS, Kohler TR, Hatsukami TS, Glickerman DG, Sobel M, Burdick TS, Pedersen K, Cleary P, Kansal N, Owens E, Estes M, Forbes BA, Sobotta C, Back M, Bandyk D, Johnson B, Shames M, Reinhard RL, Thomas SC, Hunter GC, Leon LR Jr, Westerband A, Guerra RJ, Riveros M, Mills JL Sr, Hughes JD, Escalante AM, Psalms SB, Day NN, Macsata R, Sidawy A, Weiswasser J, Arora S, Jasper BJ, Dardik A, Gahtan V, Muhs BE, Sumpio BE, Gusberg RJ, Spector M, Pollak J, Aruny J, Kelly E, Wong J, Vasilas P, Joncas C, Gelabert HA, DeVirgillio C, Rigberg DA, Cole L, Lederle FA, Freischlag JA, Kohler TR, Latts E, Matsumura J, Padberg FT Jr, Kyriakides TC, O'Connor T, Snodgrass AJ, Swanson KM, Stroupe KT, Jonk Y, Guarino P, Peduzzi P, Antonelli M, Cushing C, Davis E, Durant L, Joyner S, Kossack A, Kyriakides TC, LeGwin M, McBride V, O'Connor T, Poulton J, Stratton S, Zellner S, Snodgrass AJ, Thornton J, Swanson KM, Haakenson CM, Stroupe KT, Jonk Y, Hallett JJ, Hertzer N, Towne J, Katz DA, Karrison T, Matts JP, Marottoli R, Kasl S, Mehta R, Feldman R, Farrell W, Allore H, Perry E, Niederman J, Randall F, Zeman M, Beckwith D, O'Leary TJ, Huang GD, Latts E, Bader M.

Author information

  • 1Veterans Affairs Medical Center in Hines, Minneapolis, MN 55417, USA.

Abstract

OBJECTIVE:

This study was conducted to determine the costs and comparative cost-effectiveness of two methods of abdominal aortic aneurysm (AAA) repair in the Open Versus Endovascular Repair (OVER) Veterans Affairs (VA) Cooperative Study, a multicenter randomized trial of 881 patients.

METHODS:

The primary outcomes of this analysis were mean total health care cost per life-year and per quality-adjusted life-year (QALY) from randomization to 2 years after. QALYs were calculated from EuroQol (EQ)-5D questionnaires collected at baseline and annually. Health care utilization data were obtained directly from patients and from national VA and Medicare data sources. VA costs were obtained from national VA sources using methods previously developed by the VA Health Economics Resource Center. Costs for non-VA care were determined from Medicare claims data or billing data from the patient's health care providers.

RESULTS:

After 2 years of follow-up, mean life-years were 1.78 in the endovascular repair group and 1.74 in the open repair group (difference, 0.04; 95% confidence interval [CI], -0.03 to 0.09; P = .29). Mean QALYs were 1.462 in the endovascular group and 1.461 in the open group (difference adjusting for baseline EQ-5D score, 0.006; 95% CI, -0.038 to 0.052; P = .78). Mean graft costs were higher in the endovascular group ($14,052 vs $1363; P < .001), but length of stay was shorter (5.0 vs 10.5 days; P < .001), resulting in a lower mean cost of the hospital admission for the AAA procedure in the endovascular repair group of $37,068 vs $42,970 (difference, -$5901; 95% CI, -$12,135 to -$821; P = .04). After 2 years, total health care costs remained lower in the endovascular group, but the difference was no longer significant (-$5019; 95% CI, -$16,720 to $4928; P = .35). The probability of endovascular repair being less costly and more effective was 70.9% for life-years and 51.4% for QALYs.

CONCLUSIONS:

In this multicenter randomized trial, endovascular AAA repair resulted in lower cost and better survival than open repair after the initial hospitalization for repair; but after 2 years, survival, quality of life, and costs were not significantly different between the two treatments.

Published by Mosby, Inc.

Comment in

  • Invited commentary. [J Vasc Surg. 2012]
PMID:
22640466
[PubMed - indexed for MEDLINE]
Free full text
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk