Cost of preventing variceal rebleeding with transjugular intrahepatic portal systemic shunt and distal splenorenal shunt

Thomas D. Boyer, J. Michael Henderson, Adrienne M. Heerey, Susana Arrigain, Vicky Konig, Jason Connor, Kareem Abu-Elmagd, John Galloway, Layton F. Rikkers, Lennox J Jeffers

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Background/Aims: We examined the cost and cost effectiveness of distal splenorenal shunt (DSRS) and transjugular intrahepatic portosystemic shunt (TIPS) in the prevention of variceal rebleeding. Methods: Patients participated in a randomized controlled trial comparing DSRS to TIPS. Quality of life (QOL) was measured using SF-36 preceding randomization and yearly thereafter. Cost utility analysis was performed using TreeAge DATA®. Costs for both in- and out-patient events and interventions were obtained for each patient. Costs using coated stents were estimated using different rates of stenosis. Incremental cost effectiveness ratios (ICERs) were determined at 1, 3 and 5 years. Results: The average yearly costs of managing patients after TIPS and DSRS over 5 years were similar, $16,363 and $13,492, respectively. Cost of TIPS for surviving patients exceeded the cost of DSRS at years 3 and 5 but not significantly. ICERs per life saved favored TIPS at year 5 ($61,000). If coated rather than bare stents were used the cost effectiveness of TIPS increased slightly. Conclusions: TIPS is as effective as DSRS in preventing variceal rebleeding and may be more cost effective. TIPS, in all aspects, is equal to DSRS in the prevention of variceal rebleeding in patients who are medical failures.

Original languageEnglish
Pages (from-to)407-414
Number of pages8
JournalJournal of Hepatology
Volume48
Issue number3
DOIs
StatePublished - Mar 1 2008
Externally publishedYes

Fingerprint

Surgical Splenorenal Shunt
Transjugular Intrahepatic Portasystemic Shunt
Costs and Cost Analysis
Cost-Benefit Analysis
Stents
Random Allocation
Pathologic Constriction
Outpatients
Randomized Controlled Trials
Quality of Life

Keywords

  • Bleeding varices
  • Cost effectiveness
  • Shunts
  • TIPS

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Boyer, T. D., Henderson, J. M., Heerey, A. M., Arrigain, S., Konig, V., Connor, J., ... Jeffers, L. J. (2008). Cost of preventing variceal rebleeding with transjugular intrahepatic portal systemic shunt and distal splenorenal shunt. Journal of Hepatology, 48(3), 407-414. https://doi.org/10.1016/j.jhep.2007.08.014

Cost of preventing variceal rebleeding with transjugular intrahepatic portal systemic shunt and distal splenorenal shunt. / Boyer, Thomas D.; Henderson, J. Michael; Heerey, Adrienne M.; Arrigain, Susana; Konig, Vicky; Connor, Jason; Abu-Elmagd, Kareem; Galloway, John; Rikkers, Layton F.; Jeffers, Lennox J.

In: Journal of Hepatology, Vol. 48, No. 3, 01.03.2008, p. 407-414.

Research output: Contribution to journalArticle

Boyer, TD, Henderson, JM, Heerey, AM, Arrigain, S, Konig, V, Connor, J, Abu-Elmagd, K, Galloway, J, Rikkers, LF & Jeffers, LJ 2008, 'Cost of preventing variceal rebleeding with transjugular intrahepatic portal systemic shunt and distal splenorenal shunt', Journal of Hepatology, vol. 48, no. 3, pp. 407-414. https://doi.org/10.1016/j.jhep.2007.08.014
Boyer, Thomas D. ; Henderson, J. Michael ; Heerey, Adrienne M. ; Arrigain, Susana ; Konig, Vicky ; Connor, Jason ; Abu-Elmagd, Kareem ; Galloway, John ; Rikkers, Layton F. ; Jeffers, Lennox J. / Cost of preventing variceal rebleeding with transjugular intrahepatic portal systemic shunt and distal splenorenal shunt. In: Journal of Hepatology. 2008 ; Vol. 48, No. 3. pp. 407-414.
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