Cost-effectiveness of endoscopic versus open harvest of a short saphenous vein segment for coronary artery bypass grafting A post hoc health economic evaluation of a randomised controlled trial Background calculate the incremental cost-effectiveness ratio (ICER) and to construct A saphenous vein segment is acceptability curves (CEACs). commonly used as a conduit for coronary Results were tested against a artery bypass grafting (CABG), and clinicians pay (WTP) threshold of £ 30,000/quality must decide whether to obtain it by adjusted life-years (QALY). performing a traditional open vein harvest (OVH) or by performing an endoscopic vein harvest (EVH). We conducted a post hoc When costs and outcomes within the analysis (CUA), based on a published first 35 days were compared, the ICER was £ study and from the Danish healthcare 64,482/QALY but <1 % cost-effective at a system´s viewpoint, to investigate whether WTP of £ 30,000/QALY. Adding costs of EVH is cost-effective when compared to OVH. treatments of surgical wound infections of the leg, which were already initiated at 35 days postoperatively, the ICER dropped to £ The economic analysis was performed 38,876/QALY, and EVH became using a 35 day follow-up period and in approximately 2 % cost-effective at a WTP of accordance with international guidelines. We £ 30,000/QALY. If mobility was excluded from constructed four cost-levels as the current the measurement of outcome, EVH was <1 % literature is inconclusive as to which resource cost-effective at a WTP of £ 30,000/QALY. consumptions differ significantly between EVH and OVH. Outcomes were assessed by performing a quality of life conversion of We conclude that, within the first five patients´ postoperative pain, satisfaction with weeks postoperatively, EVH is not a cosmetic results and observational data on method for harvesting a short mobility. We performed bias corrected saphenous vein segment during CABG, when bootstrap analyses on 5,000 re-samples to compared to OVH.
Cost-effectiveness of endoscopic versus open harvest of a short saphenous vein segment for coronary artery bypass grafting A post hoc health economic evaluation of a randomised controlled trial Background A saphenous vein segment is commonly used as a conduit for coronary artery bypass grafting (CABG), and clinicians must decide whether to obtain it by performing a traditional open vein harvest (OVH) or by performing an endoscopic vein harvest (EVH). We conducted a post hoc analysis (CUA), based on a published study and from the Danish healthcare system´s viewpoint, to investigate whether EVH is cost-effective when compared to OVH. The economic analysis was performed using a 35 day follow-up period and in accordance with international guidelines. We constructed four cost-levels as the current literature is inconclusive as to which resource consumptions differ significantly between EVH and OVH. Outcomes were assessed by performing a quality of life conversion of patients´ postoperative pain, satisfaction with cosmetic results and observational data on mobility. We performed bias corrected bootstrap analyses on 5,000 re-samples to calculate the incremental cost-effectiveness ratio (ICER) and to construct acceptability curves (CEACs). Results were tested against a (WTP) threshold of £ 30,000/quality adjusted life-years (QALY). When costs and outcomes within the first 35 days were compared, the ICER was £ 64,482/QALY but <1 % cost-effective at a WTP of £ 30,000/QALY. Adding costs of treatments of surgical wound infections of the leg, which were already initiated at 35 days postoperatively, the ICER dropped to £ 38,876/QALY, and EVH became approximately 2 % cost-effective at a WTP of £ 30,000/QALY. If mobility was excluded from the measurement of outcome, EVH was <1 % cost-effective at a WTP of £ 30,000/QALY. We conclude that, within the first five weeks postoperatively, EVH is not a method for harvesting a short saphenous vein segment during CABG, when compared to OVH. pay
Cost_effectiveness_of_endoscopic_versus_open_harvest_of_a_short_saphenous_vein_segment_for_coronary_artery_bypass_grafting.docx