Cost-utility analysis of great saphenous vein ablation with radiofrequency, foam and surgery in the emerging health-care setting of Thailand (2015)

Boonying Siribumrungwong1, Pinit Noorit2,
Chumpon Wilasrusmee3, Pattara Leelahavarong4,
Ammarin Thakkinstian5 and Yot Teerawattananon4

Abstract
Objectives: To conduct economic evaluations of radiofrequency ablation, ultrasound-guided foam sclerotherapy and surgery for great saphenous vein ablation.

Method: A cost-utility and cohort analysis from societal perspective was performed to estimate incremental costeffectiveness ratio. Transitional probabilities were from meta-analysis. Direct medical, direct non-medical, indirect costs,
and utility were from standard Thai costings and cohort. Probabilistic sensitivity analysis was performed to assess parameter uncertainties.

Results: Seventy-seven patients (31 radiofrequency ablation, 19 ultrasound-guided foam sclerotherapy, and 27 surgeries) were enrolled from October 2011 to February 2013. Compared with surgery, radiofrequency ablation costed 12,935 and
20,872 Baht higher, whereas ultrasound-guided foam sclerotherapy costed 6159 lower and 1558 Bath higher for outpatient and inpatient, respectively. At one year, radiofrequency ablation had slightly lower quality-adjusted life-year,
whereas ultrasound-guided foam sclerotherapy yielded additional 0.025 quality-adjusted life-year gained. Because of costing lower and greater quality-adjusted life-year than other compared alternatives, outpatient ultrasound-guided
foam sclerotherapy was an option being dominant. Probabilistic sensitivity analysis resulted that at the Thai ceiling threshold of 160,000 Baht/quality-adjusted life-year gained, ultrasound-guided foam sclerotherapy had chances of 0.71
to be cost-effective.

Conclusions: Ultrasound-guided foam sclerotherapy seems to be cost-effective for treating great saphenous vein reflux compared to surgery in Thailand at one-year results.

Full text can be accessed from: http://phl.sagepub.com/content/early/2015/09/04/0268355515604258.abstract