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Cost-effectiveness of the National Health Service abdominal aortic aneurysm screening programme in England

Glover, M. J., Kim, L. G., Sweeting, M. J., Thompson, S. G. and Buxton, M. J. (2014) Cost-effectiveness of the National Health Service abdominal aortic aneurysm screening programme in England British Journal of Surgery, 101 (8). pp. 976-982.

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Abstract

Background

Implementation of the National Health Service abdominal aortic aneurysm (AAA) screening programme (NAAASP) for men aged 65 years began in England in 2009. An important element of the evidence base supporting its introduction was the economic modelling of the long‐term cost‐effectiveness of screening, which was based mainly on 4‐year follow‐up data from the Multicentre Aneurysm Screening Study (MASS) randomized trial. Concern has been expressed about whether this conclusion of cost‐effectiveness still holds, given the early performance parameters, particularly the lower prevalence of AAA observed in NAAASP.

Methods

The existing published model was adjusted and updated to reflect the current best evidence. It was recalibrated to mirror the 10‐year follow‐up data from MASS; the main cost parameters were re‐estimated to reflect current practice; and more robust estimates of AAA growth and rupture rates from recent meta‐analyses were incorporated, as were key parameters as observed in NAAASP (attendance rates, AAA prevalence and size distributions).

Results

The revised and updated model produced estimates of the long‐term incremental cost‐effectiveness of £5758 (95 per cent confidence interval £4285 to £7410) per life‐year gained, or £7370 (£5467 to £9443) per quality‐adjusted life‐year (QALY) gained.

Conclusion

Although the updated parameters, particularly the increased costs and lower AAA prevalence, have increased the cost per QALY, the latest modelling provides evidence that AAA screening as now being implemented in England is still highly cost‐effective.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine
Authors :
NameEmailORCID
Glover, M. J.matthew.glover@surrey.ac.uk
Kim, L. G.
Sweeting, M. J.
Thompson, S. G.
Buxton, M. J.
Date : 10 June 2014
Funders : National Institute for Health Research (NIHR)
DOI : 10.1002/bjs.9528
OA Location : http://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC4231222&blobtype=pdf
Grant Title : Health Technology Assessment Programme
Copyright Disclaimer : © 2014 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
Depositing User : Clive Harris
Date Deposited : 29 Apr 2020 16:14
Last Modified : 29 Apr 2020 16:14
URI: http://epubs.surrey.ac.uk/id/eprint/855411

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