Key result
Aspirin plus colonoscopy surveillance in post-polypectomy patients costs ~$61,000 per life-year saved versus no intervention.
Why the study?
The cost-effectiveness of aspirin chemoprevention in individuals with prior adenoma resection has not been evaluated.
Is aspirin chemoprevention alone or combined with colonoscopy surveillance cost-effective in patients with prior adenoma resection?
Is aspirin chemoprevention alone or combined with colonoscopy surveillance cost-effective in patients with prior adenoma resection?
Effect estimate: ICER $60,942 per year of life saved
Aspirin chemoprevention combined with colonoscopic surveillance may be a cost-effective strategy for patients with prior adenoma resection.
May support combined aspirin and surveillance as potentially cost-effective post-polypectomy; leaves open need for randomized confirmation before practice change.
BACKGROUND: Aspirin chemoprevention combined with colonoscopy screening is not cost-effective for the general population. However, the cost-effectiveness of aspirin in individuals with prior adenoma resection has not been evaluated. AIM: To evaluate the cost-effectiveness of aspirin chemoprevention alone and in combination with colonoscopy surveillance in patients with prior adenoma resection. METHODS: A model of the natural history of individuals with a history of endoscopic polypectomy was constructed. Four strategies were compared: (i) no intervention, (ii) routine colonoscopy surveillance, (iii) aspirin chemoprevention alone, and (iv) aspirin therapy combined with colonoscopy. RESULTS: Compared with no intervention, all other strategies were more costly but were associated with gains in years of life saved. Aspirin chemoprevention alone was associated with a gain of 0.0092 years, whereas routine colonoscopic surveillance and combination strategy were associated with further gains in years of life saved (0.0124 and 0.0138 years, respectively). Compared with no intervention, the incremental cost-effectiveness ratio of routine colonoscopy surveillance was $78,226 per year of life saved, and the incremental cost-effectiveness ratio of combination aspirin and colonoscopy was $60,942 per year of life saved. CONCLUSION: Aspirin chemoprevention combined with colonoscopic surveillance in post-polypectomy patients may be considered a cost-effective strategy.
No takes yet. Share an insight, caveat, or question.
Dupont et al. (2007) studied Prior adenoma resection. Aspirin chemoprevention combined with colonoscopy surveillance vs. No intervention was evaluated on Incremental cost-effectiveness ratio per year of life saved (ICER $60,942 per year of life saved). Aspirin chemoprevention combined with colonoscopic surveillance in post-polypectomy patients yielded an incremental cost-effectiveness ratio of $60,942 per year of life saved compared with no intervention.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: