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"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  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  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  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 "
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