Cost-Utility Analysis of Carotid Artery Angioplasty and Carotid Endarterectomy in Iran

Mohammad  Taghi Ashoobi; Sara  Zahedfar; Hossein  Hemmati; Enayatollah  Homaie Rad

doi:10.18502/htaa.v9i2.18715

Mohammad Taghi Ashoobi Guilan Road Trauma Research Center, Trauma Institute, Guilan University of Medical Sciences, Rasht, Iran.
Sara Zahedfar Razi Clinical Research Development Center, Guilan University of Medical Sciences, Rasht, Iran.
Hossein Hemmati Guilan Road Trauma Research Center, Trauma Institute, Guilan University of Medical Sciences, Rasht, Iran.
Enayatollah Homaie Rad Social Determinants of Health Research Center, Trauma Institute, Guilan University of Medical Sciences, Rasht, Iran.

DOI: https://doi.org/10.18502/htaa.v9i2.18715

Keywords: Cost Utility; Economics Evaluation; Carotid Artery Angioplasty; Carotid Endarterectomy

Abstract

Background: Carotid artery stenting (CAS) and carotid endarterectomy (CEA) are two standard methods for the prevention and treatment of cerebrovascular accidents.

Objectives: This study compared these two methods using an economic evaluation analysis.

Methods: One hundred patients with carotid occlusive disease at Razi Hospital in Rasht, Iran, were analyzed in a retrospective cost-utility study using the SF-12 Questionnaire to calculate quality-adjusted life year (QALY) and costs from a societal perspective. This study employed Monte Carlo simulation and sensitivity analysis for data analysis.

Results: Of the 100 patients, 61 were male, and 64 underwent CEA treatment. The incremental cost-effectiveness ratio (ICER) of CAS versus CEA was US$ 213.6 (± 111.2). The ICER increased to US$ 1625.6 when governmental currency exchange subsidies were excluded from the cost calculations of the two methods.

Conclusions: Both the costs and QALY of CAS are higher than those of CEA. The CAS is cost-effective when the preferred currency rate is applied to medical equipment pricing [compared to the willingness to pay (WTP) threshold of US$ 1431.85]. However, it is not cost-effective when government subsidies are removed.