Cost-utility analysis of stenting versus endarterectomy in the international carotid stenting study
<p>BACKGROUND: The International Carotid Stenting Study was a multicenter randomized trial in which patients with symptomatic carotid artery stenosis were randomly allocated to treatment by carotid stenting or endarterectomy. Economic evidence comparing these treatments is limited and inconsis...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
SAGE Publications
2016
|
| _version_ | 1826262566054133760 |
|---|---|
| author | Morris, S Patel, N Dobson, J Featherstone, R Richards, T Luengo-Fernandez, R Rothwell, P Brown, M |
| author_facet | Morris, S Patel, N Dobson, J Featherstone, R Richards, T Luengo-Fernandez, R Rothwell, P Brown, M |
| author_sort | Morris, S |
| collection | OXFORD |
| description | <p>BACKGROUND: The International Carotid Stenting Study was a multicenter randomized trial in which patients with symptomatic carotid artery stenosis were randomly allocated to treatment by carotid stenting or endarterectomy. Economic evidence comparing these treatments is limited and inconsistent.</p> <p>AIMS:We compared the cost-effectiveness of stenting versus endarterectomy using International Carotid Stenting Study data.</p> <p>METHODS:We performed a cost-utility analysis estimating mean costs and quality-adjusted life years per patient for both treatments over a five-year time horizon based on resource use data and utility values collected in the trial. Costs of managing stroke events were estimated using individual patient data from a UK population-based study (Oxford Vascular Study).</p> <p>RESULTS:Mean costs per patient (95% CI) were USD10,477 (USD9669 to USD11,285) in the stenting group (N = 853) and USD9669 (USD8835 to USD10,504) in the endarterectomy group (N = 857). There were no differences in mean quality-adjusted life years per patient (3.247 (3.160 to 3.333) and 3.228 (3.150 to 3.306), respectively). There were no differences in adjusted costs between groups (mean incremental costs for stenting versus endarterectomy $736 (95% CI -USD353 to USD1826)) or adjusted outcomes (mean quality-adjusted life years gained -0.010 (95% CI -0.117 to 0.097)). The incremental net monetary benefit for stenting versus endarterectomy was not significantly different from zero at the maximum willingness to pay for a quality-adjusted life year commonly used in the UK. Sensitivity analyses showed little uncertainty in these findings.</p> <p>CONCLUSIONS:Economic considerations should not affect whether patients with symptomatic carotid stenosis undergo stenting or endarterectomy.</p> |
| first_indexed | 2024-03-06T19:38:14Z |
| format | Journal article |
| id | oxford-uuid:1fc2599e-ee5e-4e0c-a718-019542a5dcb7 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T19:38:14Z |
| publishDate | 2016 |
| publisher | SAGE Publications |
| record_format | dspace |
| spelling | oxford-uuid:1fc2599e-ee5e-4e0c-a718-019542a5dcb72022-03-26T11:23:49ZCost-utility analysis of stenting versus endarterectomy in the international carotid stenting studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:1fc2599e-ee5e-4e0c-a718-019542a5dcb7EnglishSymplectic Elements at OxfordSAGE Publications2016Morris, SPatel, NDobson, JFeatherstone, RRichards, TLuengo-Fernandez, RRothwell, PBrown, M<p>BACKGROUND: The International Carotid Stenting Study was a multicenter randomized trial in which patients with symptomatic carotid artery stenosis were randomly allocated to treatment by carotid stenting or endarterectomy. Economic evidence comparing these treatments is limited and inconsistent.</p> <p>AIMS:We compared the cost-effectiveness of stenting versus endarterectomy using International Carotid Stenting Study data.</p> <p>METHODS:We performed a cost-utility analysis estimating mean costs and quality-adjusted life years per patient for both treatments over a five-year time horizon based on resource use data and utility values collected in the trial. Costs of managing stroke events were estimated using individual patient data from a UK population-based study (Oxford Vascular Study).</p> <p>RESULTS:Mean costs per patient (95% CI) were USD10,477 (USD9669 to USD11,285) in the stenting group (N = 853) and USD9669 (USD8835 to USD10,504) in the endarterectomy group (N = 857). There were no differences in mean quality-adjusted life years per patient (3.247 (3.160 to 3.333) and 3.228 (3.150 to 3.306), respectively). There were no differences in adjusted costs between groups (mean incremental costs for stenting versus endarterectomy $736 (95% CI -USD353 to USD1826)) or adjusted outcomes (mean quality-adjusted life years gained -0.010 (95% CI -0.117 to 0.097)). The incremental net monetary benefit for stenting versus endarterectomy was not significantly different from zero at the maximum willingness to pay for a quality-adjusted life year commonly used in the UK. Sensitivity analyses showed little uncertainty in these findings.</p> <p>CONCLUSIONS:Economic considerations should not affect whether patients with symptomatic carotid stenosis undergo stenting or endarterectomy.</p> |
| spellingShingle | Morris, S Patel, N Dobson, J Featherstone, R Richards, T Luengo-Fernandez, R Rothwell, P Brown, M Cost-utility analysis of stenting versus endarterectomy in the international carotid stenting study |
| title | Cost-utility analysis of stenting versus endarterectomy in the international carotid stenting study |
| title_full | Cost-utility analysis of stenting versus endarterectomy in the international carotid stenting study |
| title_fullStr | Cost-utility analysis of stenting versus endarterectomy in the international carotid stenting study |
| title_full_unstemmed | Cost-utility analysis of stenting versus endarterectomy in the international carotid stenting study |
| title_short | Cost-utility analysis of stenting versus endarterectomy in the international carotid stenting study |
| title_sort | cost utility analysis of stenting versus endarterectomy in the international carotid stenting study |
| work_keys_str_mv | AT morriss costutilityanalysisofstentingversusendarterectomyintheinternationalcarotidstentingstudy AT pateln costutilityanalysisofstentingversusendarterectomyintheinternationalcarotidstentingstudy AT dobsonj costutilityanalysisofstentingversusendarterectomyintheinternationalcarotidstentingstudy AT featherstoner costutilityanalysisofstentingversusendarterectomyintheinternationalcarotidstentingstudy AT richardst costutilityanalysisofstentingversusendarterectomyintheinternationalcarotidstentingstudy AT luengofernandezr costutilityanalysisofstentingversusendarterectomyintheinternationalcarotidstentingstudy AT rothwellp costutilityanalysisofstentingversusendarterectomyintheinternationalcarotidstentingstudy AT brownm costutilityanalysisofstentingversusendarterectomyintheinternationalcarotidstentingstudy |