目的: 基于中国人群的临床产出与成本环境,评估血流导向密网支架技术对比支架辅助弹簧圈技术治疗颅内大型动脉瘤的经济性。方法: 基于文献资料,临床研究数据与真实世界成本,构建大型颅内动脉瘤的Markov模型,对血流导向密网支架技术对比支架辅助弹簧圈技术进行经济学评价。结果: 两种干预措施治疗大型颅内动脉瘤,围手术期成本分别为支架辅助弹簧圈组325543.90元,血流导向密网支架组323719.44元。治疗20年后,与支架辅助弹簧圈技术相比,血流导向密网支架技术能够节省33671.13元成本,并多获得0.5378健康生命年,ICER值为负。结论: 血流导向密网支架技术围手术期成本略低于支架辅助弹簧圈技术,长期来看,在当前价格水平下,血流导向密网支架技术治疗颅内大型/巨大型动脉瘤具有成本效果优势。
Abstract
Objective: To perform the health economic evaluation of pipeline embolization device versus stent-assisted coiling in the treatment of large intracranial aneurysms based on the clinical outcomes and cost environment of the Chinese population. Methods: Based on literature, clinical data and real world cost data, Markov model of large intracranial aneurysms was constructed. Economic evaluation was made on stent-assisted coiling technology compared with pipeline embolization device technology. Results: The perioperative cost of the two interventions in the treatment of large intracranial aneurysms was 325543.90 yuan in the stent-assisted coiling group and 323719.44 yuan in the pipeline embolization device group. After 20 years of treatment, compared with the stent-assisted coiling technology, the pipeline embolization device technology could save 33671.13 yuan cost and gain 0.5378 Quality adjusted life years (ICER value was negative). Conclusions: The perioperative cost of pipeline embolization device technology is slightly lower than that of stent-assisted coiling technology. In the long term, at current price levels, pipeline embolization device has cost-effectiveness advantage in the treatment of large/giant intracranial aneurysms.
关键词
大型颅内动脉瘤 /
血流导向密网支架 /
支架辅助弹簧圈 /
卫生经济学评价
Key words
large intracranial aneurysm /
pipeline embolization device /
stent-assisted coiling /
health economics evaluation
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