ECONOMIC EVALUATION OF CEREBRAL OXIMETRY MONITORING IN CAROTID ENDARTERECTOMY - THE EMOCAR RANDOMIZED CONTROLLED TRIAL (MAY 2011 - APRIL 2016)
Author(s)
Cabout E, Kabeshova A, Launois R
REES France, Paris, France
OBJECTIVES: The risk of cerebrovascular incidents is one of the major challenges of the carotid endarterectomy (CE)The main purpose of this study was to assess the cost-effectiveness of the cerebral oximetry monitoring compared to the usual monitoring during CE. METHODS: The economic evaluation was performed over the period following the endarterectomyThe analysis includes patients: and 340 in the intervention and experimental groups respectivelyIt was performed from the community perspectivehe outpatients and caregivers’ resource utilisation were collected with the Wilmer questionnaire. The hospital expenses were estimated through a retrospective HRG survey. QALY’s were calculated using an EQ-5D-3L scale and validated French tariffsMultiple imputations were implemented Net monetary benefit (NMB) for different values of the willingness to pay (WTP) was estimated using the linear regression technique as proposed by Hoch (1994) Deterministic and probabilistic sensitivity analyses were performed RESULTS: The costs of health care and QALYs are €10,465 and 0.301 for the control group and €10,320 and 0.289 for the experimental group. There is no significant difference between the NMB of two strategiesHowever, the regression with exogenous variables showed a center effect. Under the €10,000 threshold, the experimental strategy has a higher NMB than the control strategy. The experimental strategy is preferred to the control strategy. The break-even point of the two strategies is equal to €34,000; both strategies generate the positive benefitEach strategy contributes to improving the overall health of patients regardless the resources used CONCLUSIONS: The net monetary benefit indicates the threshold of WTP where the strategies generate a positive net benefit (health gains greater than financial losses) The endogenous identification of the break-even point is a simple tool to compare the innovation efforts in different therapeutic areas.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PMD71
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Cardiovascular Disorders