Journal of Vascular Surgery
Volume 48, Issue 4 , Pages 779-787 , October 2008

Cost-effectiveness analysis of elective endovascular repair compared with open surgical repair of abdominal aortic aneurysms for patients at a high surgical risk: A 1-year patient-level analysis conducted in Ontario, Canada

  • Jean-Eric Tarride, PhD

      Affiliations

    • Programs for Assessment of Technology in Health (PATH) Research Institute, St. Joseph's Healthcare, Hamilton, Ontario, Canada
    • Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
    • Corresponding Author InformationReprint requests: Jean-Eric Tarride, PhD, Programs for Assessment of Technology in Health (PATH) Research Institute, 25 Main St W, Ste 2000, Hamilton, ON L8P 1H1, Canada
    • ,
  • Gord Blackhouse, BComm, MBA, MSc

      Affiliations

    • Programs for Assessment of Technology in Health (PATH) Research Institute, St. Joseph's Healthcare, Hamilton, Ontario, Canada
    • Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
    • ,
  • Guy De Rose, BSc, MD

      Affiliations

    • Division of Vascular Surgery, Department of Surgery, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada
    • Division of Vascular Surgery, Department of Surgery, Faculty of Medicine, University of Western Ontario, London, Ontario, Canada
    • ,
  • Teresa Novick, RN, BA

      Affiliations

    • Division of Vascular Surgery, Department of Surgery, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada
    • ,
  • James M. Bowen, BScPhm, MSc

      Affiliations

    • Programs for Assessment of Technology in Health (PATH) Research Institute, St. Joseph's Healthcare, Hamilton, Ontario, Canada
    • Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
    • ,
  • Robert Hopkins, BA, BSc, MA

      Affiliations

    • Programs for Assessment of Technology in Health (PATH) Research Institute, St. Joseph's Healthcare, Hamilton, Ontario, Canada
    • Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
    • ,
  • Daria O'Reilly, PhD

      Affiliations

    • Programs for Assessment of Technology in Health (PATH) Research Institute, St. Joseph's Healthcare, Hamilton, Ontario, Canada
    • Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
    • ,
  • Ron Goeree, MA

      Affiliations

    • Programs for Assessment of Technology in Health (PATH) Research Institute, St. Joseph's Healthcare, Hamilton, Ontario, Canada
    • Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada

Received 6 February 2008 ,Accepted 19 May 2008.

  • Image Result

    Kaplan-Meier survival is shown for endovascular aneurysm repair (EVAR, blue line) and open surgical repair (OSR, green line) in high-risk patients at up to 365 days of follow-up.

    Kaplan-Meier survival is shown for endovascular aneurysm repair (EVAR, blue line) and open surgical repair (OSR, green line) in high-risk patients at up to 365 days of follow-up.

  • Image Result

    A, Mean utility scores for the EuroQol quality of life instrument (EQ-5D) and (B) estimated quality-adjusted life-years (QALYS) are shown for high-risk patients undergoing endovascular aneurysm repair

    A, Mean utility scores for the EuroQol quality of life instrument (EQ-5D) and (B) estimated quality-adjusted life-years (QALYS) are shown for high-risk patients undergoing endovascular aneurysm repair (EVAR, blue lines) and open surgical repair (OSR, green lines) during 365-days of follow-up.

  • Image Result
    Incremental cost and effect pairs for endovascular aneurysm repair (EVAR) vs open surgical repair (OSR) are shown for (A) incremental costs and quality-adjusted life-years (QALYs) and (B) incremental

    Incremental cost and effect pairs for endovascular aneurysm repair (EVAR) vs open surgical repair (OSR) are shown for (A) incremental costs and quality-adjusted life-years (QALYs) and (B) incremental costs and life-year (LY) gained. Each dot represents a bootstrap sample.

  • Image Result
    Cost-effectiveness acceptability curves are shown for (A) incremental costs per life-year (LY) gained and (B) incremental cost per quality-adjusted life-year (QALY) gained.

    Cost-effectiveness acceptability curves are shown for (A) incremental costs per life-year (LY) gained and (B) incremental cost per quality-adjusted life-year (QALY) gained.

 Competition of interest: none.

 This project was funded by the Ontario Ministry of Health & Long-term Care (Contract No. 06129) to address the 2002 recommendations of the Ontario Health Technology Advisory Committee regarding EVAR. The final study results were presented to the Ontario Health Technology Advisory Committee on December 15, 2006. Daria O'Reilly and Jean-Eric Tarride each hold a 2007 Career Scientist Award, Ontario Ministry of Health and Long-Term Care.

PII: S0741-5214(08)00867-7

doi: 10.1016/j.jvs.2008.05.064

Journal of Vascular Surgery
Volume 48, Issue 4 , Pages 779-787 , October 2008

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