Economic Evaluation of Abdominal Aortic Aneurysm Screening in the Czech Republic

OBJECTIVES: Abdominal aortic aneurysm (AAA) is a disease that is occurring most often in older men. AAA can be effectively detected using imaging methods including ultrasonography. A well-targeted screening program can identify an AAA at a stage when prophylactic treatment can be initiated, and the rupture of the AAA can be prevented. The aim of this study is to describe the economic evaluation of a screening program that is being prepared in the Czech Republic.

METHODS: Two models were developed for the economic evaluation: a budget impact analysis (BIA) and a simplified cost-effectiveness analysis (CEA). The BIA estimated the number of men to be screened and the cost of screening process in the first five years. The CEA modelled a cohort of 65-year-old men for the rest of their lives and estimated the benefits in terms of the number of AAA ruptures and deaths prevented in the context of the costs incurred. Estimates were based on the literature, expert opinions, and reimbursement mechanisms in the Czech Republic.

RESULTS: Based on the result of the BIA, it can be assumed that 15,000 men will be approached in the first year and 9,000 of them will participate. The cost of screening in the first year is estimated at 291,000 EUR. With increasing adherence of providers, 34,000 screening participants can be expected in the fifth year and the cost of screening in the fifth year is estimated at 1.056 million EUR. According to the results of the CEA, 25.4% decrease in AAA deaths and an increase in costs of approximately 16.7% can be expected compared to the situation without screening.

CONCLUSIONS: AAA screening appears to be cost-effective based on the results of an economic evaluation and the national reimbursement practice. With adherence to the program design, prevention of AAA rupture could be expected in many Czech men.