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COST-EFFECTIVENESS OF RADIOFREQUENCY ABLATION VERSUS LASER FOR VARICOSE VEINS

Published online by Cambridge University Press:  30 December 2015

Amanda C. Shepherd ,
Marta Ortega-Ortega ,
Manj S. Gohel ,
David Epstein ,
Louise C. Brown  and
Alun H. Davies
Amanda C. Shepherd
Affiliation:
Academic Section of Vascular Surgery, Imperial College School of Medicine, Charing Cross Hospital
Marta Ortega-Ortega
Affiliation:
Department of Applied Economics, University of Granadamortega2@ugr.es
Manj S. Gohel
Affiliation:
Academic Section of Vascular Surgery, Imperial College School of Medicine, Charing Cross Hospital; and Department of Vascular Surgery, Addenbrooke's Hospital Cambridge
David Epstein
Affiliation:
Department of Applied Economics, University of Granada
Louise C. Brown
Affiliation:
Medical Research Council, Clinical Trials Unit, University College London
Alun H. Davies
Affiliation:
Academic Section of Vascular Surgery, Imperial College School of Medicine, Charing Cross Hospital
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Abstract

Objectives: Although the clinical benefits of endovenous thermal ablation are widely recognized, few studies have evaluated the health economic implications of different treatments. This study compares 6-month clinical outcomes and cost-effectiveness of endovenous laser ablation (EVLA) compared with radiofrequency ablation (RFA) in the setting of a randomized clinical trial.

Methods: Patients with symptomatic primary varicose veins were randomized to EVLA or RFA and followed up for 6 months to evaluate clinical improvements, health related quality of life (HRQOL) and cost-effectiveness.

Results: A total of 131 patients were randomized, of which 110 attended 6-month follow-up (EVLA n = 54; RFA n = 56). Improvements in quality of life (AVVQ and SF-12v2) and Venous Clinical Severity Scores (VCSS) achieved at 6 weeks were maintained at 6 months, with no significant difference detected between treatment groups. There were no differences in treatment failure rates. There were small differences in favor of EVLA in terms of costs and 6-month HRQOL but these were not statistically significant. However, RFA is associated with less pain at up to 10 days.

Conclusions: EVLA and RFA result in comparable and significant gains in quality of life and clinical improvements at 6 months, compared with baseline values. EVLA is more likely to be cost-effective than RFA but absolute differences in costs and HRQOL are small.

Keywords

Radiofrecuency ablationEndovenous laser ablationCost-effectivenessQuality of life
Type
Assessments
Information
International Journal of Technology Assessment in Health Care , Volume 31 , Issue 5 , 2015 , pp. 289 - 296
Copyright
Copyright © Cambridge University Press 2015 

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