A vein bypass first versus a best endovascular treatment first revascularization strategy for patients with chronic limb-threatening ischaemia who require an infra-popliteal, with or without an additional more proximal infra-inguinal, revascularization procedure to restore limb perfusion:the BASIL-2 within-trial health economic analysis
| Title: | A vein bypass first versus a best endovascular treatment first revascularization strategy for patients with chronic limb-threatening ischaemia who require an infra-popliteal, with or without an additional more proximal infra-inguinal, revascularization procedure to restore limb perfusion:the BASIL-2 within-trial health economic analysis |
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| Authors: | Abdali, Zainab; Kigozi, Jesse; Moakes, Catherine A.; Bate, Gareth R.; Hall, Jack; Kelly, Lisa; Meecham, Lewis; Bradbury, Andrew W.; Popplewell, Matthew A.; Chetter, Ian; Diamantopoulos, Athanasios; Ganeshan, Arul; Hobbs, Simon; Houlind, Kim; Jarrett, Hugh; Malmstedt, Jonas; Patel, Jai V.; Rashid, Tawqeer; Saratzis, Athanasios; Scott, Julian A.; Zayed, Hany; Deeks, Jonathan J.; Gillgren, Peter; Ettles, Duncan; Claridge, Martin; Ashleigh, Ray; Wallace, Rebecca; Twine, Christopher; Richards, Toby; Chung, Lim; Rix, Thomas; Davies, Robert; Adair, Will; Stuart, Wesley; Chong, Patrick; Imray, Chris; Neary, William; Davies, Alun; Hinchliffe, Robert; Holt, Peter; Stansby, Gerard; Uberoi, Raman; Perkins, Jeremy; Wijesinghe, Lasantha; Arya, Nityanand; Goode, Stephen; Beard, Jonathan; Cleveland, Trevor; Vohra, Rajiv; Rogoveanu, Radu |
| Source: | Abdali, Z, Kigozi, J, Moakes, C A, Bate, G R, Hall, J, Kelly, L, Meecham, L, Bradbury, A W, Popplewell, M A, BASIL-2 Investigators , Chetter, I, Diamantopoulos, A, Ganeshan, A, Hobbs, S, Houlind, K, Jarrett, H, Malmstedt, J, Patel, J V, Rashid, T, Saratzis, A, Scott, J A, Zayed, H, Deeks, J J, Gillgren, P, Ettles, D, Claridge, M, Ashleigh, R, Wallace, R, Twine, C, Richards, T, Chung, L, Rix, T, Davies, R, Adair, W, Stuart, W, Chong, P, Imray, C, Neary, W, Davies, A, Hinchliffe, R, Holt, P, Stansby, G, Uberoi, R, Perkins, J, Wijesinghe, L, Arya, .... |
| Publication Year: | 2025 |
| Collection: | University of Southern Denmark: Research Output / Syddansk Universitet |
| Description: | Background Chronic limb-threatening ischaemia (CLTI) places a considerable socioeconomic burden health and social care systems worldwide. The objective of this health economic analysis was to investigate the cost-effectiveness (CEA) and cost-utility (CUA) of a vein bypass (VB) first versus a best endovascular treatment (BET) first revascularization strategy in patients with CLTI who require an infra-popliteal revascularization procedure to restore limb perfusion. Methods CEA and CUA analyses were conducted from the perspective of the UK National Health Service. Patient-level resource use and health outcomes data collected from the BASIL-2 trial over 2-7 years of follow-up were utilized to estimate incremental cost-effectiveness ratios expressed as cost per amputation-free life year (AFLY) and cost per quality-adjusted life year (QALY). EQ-5D-5L was used to generate participant QALYs at 2 and 3 years. Results At two years, the mean(s.d.) discounted hospital cost was £15 742.59(16 182.60) and £13 273.66(15 446.92) in the VB-first and BET-first revascularization strategy groups respectively. The lower costs (-£2524.23, 95% c.i., -£5844.93 to £1131.52) in the BET-first group were mainly due to the reduced number of days in hospital and lower procedural costs. BET-first was also more effective leading to additional AFLYs (0.429, 95% c.i., 0.03 to 0.88) at 7 years and discounted QALYs (0.016, 95% c.i., -0.08 to 0.12) at 2 years. Conclusion A best endovascular first revascularization strategy dominated a vein bypass first strategy in the cost-effectiveness and cost-utility analyses. The findings were robust across different scenarios and prespecified subgroups. |
| Document Type: | article in journal/newspaper |
| File Description: | application/pdf |
| Language: | English |
| ISSN: | 0007-1323; 1355-7688 |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/40580059; info:eu-repo/semantics/altIdentifier/pissn/0007-1323; info:eu-repo/semantics/altIdentifier/eissn/1355-7688 |
| DOI: | 10.1093/bjs/znaf119 |
| Availability: | https://portal.findresearcher.sdu.dk/da/publications/bbaf5248-d6a3-409c-888c-9e967fb0c687; https://doi.org/10.1093/bjs/znaf119; https://findresearcher.sdu.dk/ws/files/293746101/znaf119.pdf; https://www.scopus.com/pages/publications/105009534197 |
| Rights: | info:eu-repo/semantics/openAccess ; http://creativecommons.org/licenses/by-nc/4.0/ |
| Accession Number: | edsbas.F282467D |
| Database: | BASE |