OBJECTIVES:

This literature review aims to review and summary the current literature on health economic evaluation of pipeline embolization device for treating intracranial aneurysms.

METHODS:

We have performed a literature review through the Embase research engine, Cochrane library database, PubMed database and ISPOR publication database. The first search yielded 44 publications. After the abstract screening and the criteria assessment, 31 were excluded from the final review.

RESULTS:

A total number of 13 published studies were identified from 2012 to 2022 and they were all conducted from societal or payer perspectives. Neurosurgical clipping (NC), coiling, stent-assisted coiling (SAC) and pipeline embolization device (PED) were the main technologies for treating aneurysms. Major studies (9/13) researched patients with unruptured intracranial aneurysms and only one study from America explored the patients with ruptured intracranial aneurysms. Twelve studies reported the size of aneurysms including small, medium, large and giant. Seven studies all claimed that PED was more cost-effective than SAC or coiling in patients with large and giant aneurysms and three of the studies built a model to assess the long-term health economic results. Three studies applied models for estimating the long-term economic outcome for patients with small and medium aneurysms and they all stated that PED was a cost-effective treatment compared with SAC. In terms of short-term economic evaluation, half of the studies (2/4) indicated that the procedure cost of PED is less than coiling or SAC in patients with small and medium aneurysms. Eventually, one study reported that the upfront and follow-up costs after using coiling and PED techniques was mostly similar in patients with medium aneurysm.

CONCLUSIONS:

There was a highly consistent in the currently available economic evaluation studies, that PED is a cost-effective technique for treating different size intracranial aneurysms.