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Eur J Vasc Endovasc Surg. 2009 Mar;37(3):357-63. doi: 10.1016/j.ejvs.2008.11.013. Epub 2008 Dec 25.

Randomised comparison of costs and cost-effectiveness of cryostripping and endovenous laser ablation for varicose veins: 2-year results.

Author information

1
Department of Surgery, Mesos Medical Centre, Van Heuven Goedhartlaan 1, 3527 Utrecht, CE, The Netherlands. disselhoff@planet.nl

Abstract

BACKGROUND:

Although endovenous laser ablation for varicose veins is replacing surgical stripping, proper economic evaluation with adequate follow-up in a randomised clinical trial is important for considered policy decisions regarding the implementation of new techniques.

METHODS:

Data from a randomised controlled trial comparing cryostripping and endovenous laser ablation in 120 patients were combined to study Short Form (SF) 6D outcome, costs and cost-effectiveness 2 years after treatment. Incremental cost per quality-adjusted life year (QALY) gained 2 years after treatment was calculated using different strategies, and uncertainty was assessed with bootstrapping.

RESULTS:

Over the total study period, mean SF-6D scores improved slightly from 0.78 at baseline to 0.80 at 2 years for patients who underwent cryostripping and from 0.77 to 0.79 for patients who underwent endovenous laser. QALY (SF-6D) was 1.59 in patients who underwent cryostripping and 1.60 in patients who underwent endovenous laser 2 years after treatment. The costs of cryostripping and endovenous laser per patient were euro 2651 and euro 2783, respectively. Bootstrapping indicated that cryostripping was associated with an incremental cost-effectiveness ratio of euro 32 per QALY gained. With regard to different strategies, outpatient cryostripping was less costly and more effective 2 years after treatment.

CONCLUSION:

In this study, in terms of costs per QALY gained, outpatient cryostripping appeared to be the dominant strategy, but endovenous laser yielded comparable outcomes for a relatively little additional cost.

PMID:
19111485
DOI:
10.1016/j.ejvs.2008.11.013
[Indexed for MEDLINE]
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