A one-off abdominal ultrasound screening programme for AAA in 65-year-old men in New Zealand was estimated to be cost-effective at NZ $15,300 per QALY gained (95% UI NZ $8,700-31,000).
Does a formal AAA screening programme (one-off abdominal ultrasound) improve cost-effectiveness (cost per QALY gained) compared to no systematic screening in 65-year-old men in New Zealand?
A UK-style one-off abdominal ultrasound screening programme for AAA in 65-year-old men is estimated to be cost-effective in New Zealand.
Effect estimate: NZ $15 300 per QALY gained (95% CI NZ $8700 to 31 000)
BACKGROUND: Abdominal aortic aneurysm (AAA) rupture carries a high fatality rate. AAAs can be detected before rupture by abdominal ultrasound imaging, allowing elective repair. Population-based screening for AAA in older men reduces AAA-related mortality by about 40 per cent. The UK began an AAA screening programme offering one-off scans to men aged 65 years in 2009. Sweden has a similar programme. Currently, there is no AAA screening programme in New Zealand. This cost-utility analysis aimed to assess the cost-effectiveness of a UK-style screening programme in the New Zealand setting. METHODS: The analysis compared a formal AAA screening programme (one-off abdominal ultrasound imaging for about 20 000 men aged 65 years in 2011) with no systematic screening. A Markov macrosimulation model was adapted to estimate the health gains (in quality-adjusted life-years, QALYs), health system costs and cost-effectiveness in New Zealand. A health system perspective and lifetime horizon was adopted. RESULTS: With New Zealand-specific inputs, the adapted model produced an estimate of about NZ 15 300 (€7746) per QALY gained, with a 95 per cent uncertainty interval (UI) of NZ 8700 to 31 000 (€4405 to 15 694) per QALY gained. Health gains were estimated at 117 (95 per cent UI 53 to 212) QALYs. Health system costs were NZ 1·68 million (€850 535), with a 95 per cent UI of NZ 820 200 to 3·24 million (€415 243 to €1·65 million). CONCLUSION: Using New Zealand's gross domestic product per capita (about NZ 45 000 or €22 100) as a cost-effectiveness threshold, a UK-style AAA screening programme would be cost-effective in New Zealand.
Nair et al. (Wed,) conducted a other in Abdominal aortic aneurysm (n=20,000). Formal AAA screening programme (one-off abdominal ultrasound imaging) vs. No systematic screening was evaluated on Cost-effectiveness (cost per QALY gained) (NZ $15 300 per QALY gained, 95% CI NZ $8700 to 31 000). A one-off abdominal ultrasound screening programme for AAA in 65-year-old men in New Zealand was estimated to be cost-effective at NZ $15,300 per QALY gained (95% UI NZ $8,700-31,000).
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