Endovascular versus surgical creation of arteriovenous fistula in hemodialysis patients: Cost-effectiveness and budget impact analyses.
Arteriovenous Shunt, Surgical
/ adverse effects
Blood Vessel Prosthesis Implantation
/ adverse effects
Budgets
Clinical Decision-Making
Cost Savings
Cost-Benefit Analysis
Decision Support Techniques
Endovascular Procedures
/ adverse effects
Health Care Costs
Humans
Italy
Markov Chains
Models, Economic
National Health Programs
/ economics
Renal Dialysis
/ economics
Treatment Outcome
Endovascular procedure
WavelinQ
arteriovenous fistula
budget impact analysis
cost-effectiveness analysis
endovascular arteriovenous fistula
hemodialysis
medical devices
surgical procedure
Journal
The journal of vascular access
ISSN: 1724-6032
Titre abrégé: J Vasc Access
Pays: United States
ID NLM: 100940729
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
pubmed:
20
5
2020
medline:
14
4
2021
entrez:
20
5
2020
Statut:
ppublish
Résumé
The aim of the present study was to perform cost-effectiveness and budget impact analyses comparing endovascular arteriovenous fistula creation to surgical arteriovenous fistula creation in hemodialysis patients from the National Healthcare Service (NHS) perspective in Italy. A systematic literature review has been conducted to retrieve complications' rates after arteriovenous fistula creation procedures. One study comparing endovascular arteriovenous fistula creation, performed with WavelinQ device, to the surgical approach through propensity score matching was preferred to single-arm investigations to execute the economic evaluations. This study was chosen to populate a Markov model to project, on a time horizon of 1 year, quality adjusted life years and costs associated with endovascular arteriovenous fistula (WavelinQ) and surgical arteriovenous fistula options for both cohorts of incident and prevalent hemodialysis patients. For both incident and prevalent hemodialysis patients, endovascular arteriovenous fistula creation, performed with WavelinQ, was the dominant strategy over surgical arteriovenous fistula approach, showing less cost and better patients' quality of life. Compared to the current scenario, progressively increasing utilization rates of WavelinQ over surgical arteriovenous fistula creation in the next 5 years in incident hemodialysis patients are expected to save globally 30-36 million euros to the NHS. Endovascular arteriovenous fistula creation performed with WavelinQ could be a cost-saving strategy in comparison with the surgical approach for patients in hemodialysis. Future studies comparing different devices for endovascular arteriovenous fistula creation versus the surgical option would be needed to confirm or reject the validity of this preliminary evaluation. In the meantime, decision-makers can use these results to take decisions on the diffusion of endovascular procedures in Italy.
Identifiants
pubmed: 32425096
doi: 10.1177/1129729820921021
pmc: PMC7897778
doi:
Types de publication
Comparative Study
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
48-57Commentaires et corrections
Type : CommentIn
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