Davies L, Barbieri M, Berry E, Kelly S; International Society of Technology Assessment in Health Care. Meeting.

Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 2002; 18: abstract no. 77.

University of Manchester, School of Psychiatry and Behavioural Sciences, Manchester, linda.davies@man.ac.uk

BACKGROUND/OBJECTIVES: The purpose was to estimate the relative cost effectiveness of magnetic resonance angiography and X-ray arteriography. METHODS: Probabalistic decision analysis was used to estimate the expected costs and quality adjusted life years (QALY's) associated with magnetic resonance angiography and x-ray arteriography for 2 cases: carotid artery disease and peripheral vascular disease. The timeframe for the evaluations were 10 years for carotid artery disease and 1 year for peripheral vascular disease. Costs and outcomes occurring 1 year after the initial diagnosis were discounted at 6% and 1.5% respectively. The perspective included costs and outcomes of diagnosis, treatment and long term management to providers of health and social care and patients in the UK. Estimates of the sensitivity and specificity of magnetic resonance angiography and x-ray arteriography were derived from a systematic review of controlled clinical trials. Estimates of mortality, morbidity and quality of life due to adverse events and treatment following diagnosis were derived from clinical trial data and systematic reviews. Estimates of resource and costs were derived from local hospital accounts, national UK statistics and published cost data. RESULTS: For carotid artery disease, the 10 year expected mean cost and QALY's of magnetic resonance angiography were L5685 (95% CI 5670-5700) and 6.91 (95% CI 6.88-6.93). For x-ray arteriography, the 10 year expected mean cost and QALY's were L5875 (95% CI 5860-5895) and 6.92 (95% CI 6.89-6.94). For peripheral vascular disease, the 1 year expected mean cost and QALY's of magnetic resonance angiography were L6315 (95% CI 6370-6420) and 0.60 (95% CI 0.59-0.60). For x-ray arteriography, the 1 year expected mean cost and QALY's were L6395 (95% CI 6370-6420) and 0.61 (95% CI 0.61-0.61). Sensitivity analysis indicated that these results were robust to uncertainty in model assumptions and data. DISCUSSION: These data suggest that magnetic resonance angiography is as effective, in terms of longer term patient outcomes as x-ray arteriography. In the case of carotid artery disease, magnetic resonance angiography is less costly than x-ray arteriography. If both techniques are already available and high quality diagnostic studies can be obtained in the local setting, magnetic resonance angiography is more cost effective.

Publication Types:

• Meeting Abstracts

Keywords:

• Angiography
• Carotid Artery Diseases
• Carotid Stenosis
• Cost-Benefit Analysis
• Costs and Cost Analysis
• Decision Support Techniques
• Humans
• Magnetic Resonance Angiography
• Peripheral Vascular Diseases
• Quality-Adjusted Life Years
• Sensitivity and Specificity
• X-Rays
• diagnosis
• economics
• radiography
• hsrmtgs

Other ID:

• GWHSR0003014

UI: 102274693

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