Assessment of cost-effectiveness of surgical clipping and endovascular coil methods in the treatment of unruptured cerebral aneurysms

Abstract

Background and aim: The study aims to assess the cost-effectiveness of endovascular coiling and surgical clipping in the treatment of unruptured cerebral aneurysms.
 Materials and methods: Patients with ICD 10 I67.1 and treated with one of the two treatment methods performed at the Hacettepe University Hospitals between January 2013 and December 2015 were included in the study. The cost data in the study were obtained by analyzing patient invoices through the automation program of the university hospital. The effectiveness and treatment costs were assessed using the Markov model with the Social Security Institution’s (SSI) perspective. To generate the cost input in the model, the lifetime costs obtained based on the expert’s opinions were added to the amounts received from patient invoices. 
 Results: The study results were presented as the incremental cost-effectiveness ratio (ICER). When 3% reduction rate was applied to the costs and effectiveness data, the Quality Adjusted Life Years (QALY) was calculated as 4.39 and 1.84 for the coiling and clipping methods, respectively. Lifetime costs were 66463.40$ and 7900.27$ for the coiling and clipping methods, respectively. The incremental cost-effectiveness rate of endovascular coiling method was 22965.93.
 Conclusion: The endovascular coiling method was found to be cost-effective because the ICER score of the process is below the threshold.