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  • Djerf, HenrikGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology,Sahlgrenska University Hospital,Sahlgrenska Academy (author)

Editor's Choice - Cost Effectiveness of Primary Stenting in the Superficial Femoral Artery for Intermittent Claudication: Two Year Results of a Randomised Multicentre Trial

  • Article/chapterEnglish2021

Publisher, publication year, extent ...

  • Elsevier BV,2021

Numbers

  • LIBRIS-ID:oai:gup.ub.gu.se/309845
  • https://gup.ub.gu.se/publication/309845URI
  • https://doi.org/10.1016/j.ejvs.2021.07.009DOI
  • https://lup.lub.lu.se/record/219f234c-2c1a-4ca8-82ac-616e1731062eURI

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  • Language:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Objective: Invasive treatment of intermittent claudication (IC) is commonly performed, despite limited evidence of its cost effectiveness. IC symptoms aremainly caused by atherosclerotic lesions in the superficial femoral artery (SFA), and endovascular treatment is performed frequently. The aimof this studywas to investigate its cost effectiveness vs. noninvasive treatment. Methods: One hundred patients with IC due to lesions in the SFA were randomised to treatment with primary stenting, best medical treatment (BMT) and exercise advice (stent group), or to BMT and exercise advice alone (control group). Patients were recruited at seven hospitals in Sweden. For this analysis of cost effectiveness after 24 months, 84 patients with data on quality adjusted life years (QALY; based on the EuroQol Five Dimensions EQ5D 3L (TM) questionnaire) were analysed. Patient registry and imputed cost data were used for accumulated costs regarding hospitalisation and outpatient visits. Results: The mean cost per patient was (SIC)11 060 in the stent group and (SIC)4 787 in the control group, resulting in a difference of (SIC)6 273 per patient between the groups.The difference in mean QALYs between the groups was 0.26, in favour of the stent group, which resulted in an incremental cost effectiveness ratio (ICER) of (SIC)23 785 per QALY. Conclusion: The costs associated with primary stenting in the SFA for the treatment of IC were higher than for exercise advice and BMT alone. With concurrent improvement in health related quality of life, primary stenting was a cost effective treatment option according to the Swedish national guidelines (ICER < (SIC)50 000 - (SIC)70 000) and approaching the UK's National Institute for Health and Care Excellence threshold for willingness to pay (ICER < 20 pound 000 - 30 pound 000). From a cost effectiveness standpoint, primary stenting of the SFA can, in many countries, be used as an adjunct to exercise training advice, but it must be considered that successful implementation of structured exercise programmes and longer follow up may alter these findings.

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  • Svensson, Mikael,1980University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine,Sahlgrenska Academy(Swepub:gu)xsmika (author)
  • Nordanstig, JoakimGothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,Sahlgrenska University Hospital,Sahlgrenska Academy(Swepub:gu)xnjoak (author)
  • Gottsäter, AndersLund University,Lunds universitet,Internmedicin - epidemiologi,Forskargrupper vid Lunds universitet,Internal Medicine - Epidemiology,Lund University Research Groups,Skåne University Hospital(Swepub:lu)medf-ago (author)
  • Falkenberg, Mårten,1959Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology,Sahlgrenska Academy(Swepub:gu)xfalke (author)
  • Lindgren, HansHelsingborg Hospital,Skåne University Hospital(Swepub:lu)med-hlg (author)
  • Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för radiologi (creator_code:org_t)

Related titles

  • In:European Journal of Vascular and Endovascular Surgery: Elsevier BV62:4, s. 576-5821078-5884

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