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Title: Cost-effectiveness of the National Health Service abdominal aortic aneurysm screening programme in England
Authors: Glover, MJ
Kim, LG
Sweeting, MJ
Thompson, SG
Buxton, MJ
Keywords: National Health Service abdominal aortic aneurysm (AAA);Economic modelling of the long-term;Multicentre Aneurysm Screening Study (MASS)
Issue Date: 2014
Publisher: Wiley Online Library
Citation: British Journal of Surgery, 101:8, pp. 976 - 982, 2014
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 costeffectiveness 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.
Description: This article has been made available through the Brunel Open Access Publishing Fund.
ISSN: 0007-1323
Appears in Collections:Brunel OA Publishing Fund
Health Economics Research Group (HERG)

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