Publication

Cost-effectiveness of preventive treatment of intracranial aneurysms New data and uncertainties

Greving, J. P., Rinkel, G. J. E., Buskens, E. & Algra, A., 28-Jul-2009, In : Neurology. 73, 4, p. 258-265 8 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Greving, J. P., Rinkel, G. J. E., Buskens, E., & Algra, A. (2009). Cost-effectiveness of preventive treatment of intracranial aneurysms New data and uncertainties. Neurology, 73(4), 258-265. https://doi.org/10.1212/01.wnl.0b013e3181a2a4ea

Author

Greving, Jacoba P. ; Rinkel, Gabriel J. E. ; Buskens, Erik ; Algra, Ale. / Cost-effectiveness of preventive treatment of intracranial aneurysms New data and uncertainties. In: Neurology. 2009 ; Vol. 73, No. 4. pp. 258-265.

Harvard

Greving, JP, Rinkel, GJE, Buskens, E & Algra, A 2009, 'Cost-effectiveness of preventive treatment of intracranial aneurysms New data and uncertainties', Neurology, vol. 73, no. 4, pp. 258-265. https://doi.org/10.1212/01.wnl.0b013e3181a2a4ea

Standard

Cost-effectiveness of preventive treatment of intracranial aneurysms New data and uncertainties. / Greving, Jacoba P.; Rinkel, Gabriel J. E.; Buskens, Erik; Algra, Ale.

In: Neurology, Vol. 73, No. 4, 28.07.2009, p. 258-265.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Greving JP, Rinkel GJE, Buskens E, Algra A. Cost-effectiveness of preventive treatment of intracranial aneurysms New data and uncertainties. Neurology. 2009 Jul 28;73(4):258-265. https://doi.org/10.1212/01.wnl.0b013e3181a2a4ea


BibTeX

@article{c6778996f258482fb17710ce32413a81,
title = "Cost-effectiveness of preventive treatment of intracranial aneurysms New data and uncertainties",
abstract = "Background: Previous modeling studies on treatment of unruptured intracranial aneurysms largely disregarded detailed data on treatment risks and omitted several factors that could influence cost-effectiveness. We performed a cost-effectiveness analysis of surgical and endovascular treatment of unruptured aneurysms for different rupture rates and life expectancies, and assessed the influence of excess mortality risks in these persons, de novo development of aneurysms, and utility of awareness of having an untreated aneurysm, and also identified important factors for which data are lacking.Methods: We used a Markov model to compare surgical, endovascular, and no treatment of unruptured intracranial aneurysms. Inputs for the model were taken mainly from meta-analyses. Direct medical costs were derived from Dutch cost studies and expressed in 2005 Euros. We performed sensitivity analyses to evaluate model robustness.Results: For 50-year-old patients, treatment of unruptured aneurysms is cost-effective for all rupture rate scenarios between 0.3{\%} and 3.5{\%}/year. In 70-year-old patients, treatment is not cost-effective in men with rupture ratesConclusions: Patients' life expectancy, risk of rupture, and utility of awareness of an untreated aneurysm mainly define cost-effectiveness. However, important uncertainties remain on the rupture risk according to size and location of the aneurysm and on the utility of awareness of untreated aneurysm. More data on these factors are needed to define and individualize cost-effectiveness analyses. Neurology (R) 2009; 73: 258-265",
keywords = "TERM-FOLLOW-UP, UNRUPTURED CEREBRAL ANEURYSMS, SUBARACHNOID HEMORRHAGE, NATURAL-HISTORY, ENDOVASCULAR TREATMENT, DETACHABLE COILS, CASE-FATALITY, RISK, RUPTURE, METAANALYSIS",
author = "Greving, {Jacoba P.} and Rinkel, {Gabriel J. E.} and Erik Buskens and Ale Algra",
year = "2009",
month = "7",
day = "28",
doi = "10.1212/01.wnl.0b013e3181a2a4ea",
language = "English",
volume = "73",
pages = "258--265",
journal = "Neurology",
issn = "0028-3878",
publisher = "LIPPINCOTT WILLIAMS & WILKINS",
number = "4",

}

RIS

TY - JOUR

T1 - Cost-effectiveness of preventive treatment of intracranial aneurysms New data and uncertainties

AU - Greving, Jacoba P.

AU - Rinkel, Gabriel J. E.

AU - Buskens, Erik

AU - Algra, Ale

PY - 2009/7/28

Y1 - 2009/7/28

N2 - Background: Previous modeling studies on treatment of unruptured intracranial aneurysms largely disregarded detailed data on treatment risks and omitted several factors that could influence cost-effectiveness. We performed a cost-effectiveness analysis of surgical and endovascular treatment of unruptured aneurysms for different rupture rates and life expectancies, and assessed the influence of excess mortality risks in these persons, de novo development of aneurysms, and utility of awareness of having an untreated aneurysm, and also identified important factors for which data are lacking.Methods: We used a Markov model to compare surgical, endovascular, and no treatment of unruptured intracranial aneurysms. Inputs for the model were taken mainly from meta-analyses. Direct medical costs were derived from Dutch cost studies and expressed in 2005 Euros. We performed sensitivity analyses to evaluate model robustness.Results: For 50-year-old patients, treatment of unruptured aneurysms is cost-effective for all rupture rate scenarios between 0.3% and 3.5%/year. In 70-year-old patients, treatment is not cost-effective in men with rupture ratesConclusions: Patients' life expectancy, risk of rupture, and utility of awareness of an untreated aneurysm mainly define cost-effectiveness. However, important uncertainties remain on the rupture risk according to size and location of the aneurysm and on the utility of awareness of untreated aneurysm. More data on these factors are needed to define and individualize cost-effectiveness analyses. Neurology (R) 2009; 73: 258-265

AB - Background: Previous modeling studies on treatment of unruptured intracranial aneurysms largely disregarded detailed data on treatment risks and omitted several factors that could influence cost-effectiveness. We performed a cost-effectiveness analysis of surgical and endovascular treatment of unruptured aneurysms for different rupture rates and life expectancies, and assessed the influence of excess mortality risks in these persons, de novo development of aneurysms, and utility of awareness of having an untreated aneurysm, and also identified important factors for which data are lacking.Methods: We used a Markov model to compare surgical, endovascular, and no treatment of unruptured intracranial aneurysms. Inputs for the model were taken mainly from meta-analyses. Direct medical costs were derived from Dutch cost studies and expressed in 2005 Euros. We performed sensitivity analyses to evaluate model robustness.Results: For 50-year-old patients, treatment of unruptured aneurysms is cost-effective for all rupture rate scenarios between 0.3% and 3.5%/year. In 70-year-old patients, treatment is not cost-effective in men with rupture ratesConclusions: Patients' life expectancy, risk of rupture, and utility of awareness of an untreated aneurysm mainly define cost-effectiveness. However, important uncertainties remain on the rupture risk according to size and location of the aneurysm and on the utility of awareness of untreated aneurysm. More data on these factors are needed to define and individualize cost-effectiveness analyses. Neurology (R) 2009; 73: 258-265

KW - TERM-FOLLOW-UP

KW - UNRUPTURED CEREBRAL ANEURYSMS

KW - SUBARACHNOID HEMORRHAGE

KW - NATURAL-HISTORY

KW - ENDOVASCULAR TREATMENT

KW - DETACHABLE COILS

KW - CASE-FATALITY

KW - RISK

KW - RUPTURE

KW - METAANALYSIS

U2 - 10.1212/01.wnl.0b013e3181a2a4ea

DO - 10.1212/01.wnl.0b013e3181a2a4ea

M3 - Article

VL - 73

SP - 258

EP - 265

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 4

ER -

ID: 2673983