Result card

  • ECO3: What are the unit costs of the resources used when delivering population-based screening for Abdominal Aorta Aneurysm, or no screening for AAA?
English

What are the unit costs of the resources used when delivering population-based screening for Abdominal Aorta Aneurysm, or no screening for AAA?

Authors: Suvi Mäklin, Taru Haula, Kristian Lampe, Jaana Leipälä, Ulla Saalasti-Koskinen

Internal reviewers: Aurora Llanos-Mendez, Sergio Marquez, Urs Brügger, Mark Pletscher, Iñaki Imaz, Sonia García Pérez

Acknowledgments: Information Specialist Jaana Isojärvi (FINOHTA/THL, Finland)

The unit costs of AAA screening in Finland were estimated using the actual cost data from AAA patients in the hospital district of Helsinki and Uusimaa from the year 2010. Unit costs for ultrasound examination, computer tomography, and elective and emergency surgery for AAA were estimated. Costs of long-term consequences (e.g. possible rehabilitation after the intervention) were not included. The cost estimates include only the costs for healthcare sector; other costs to society, and private costs for patients and their relatives were excluded from this analysis.

The Finnish data were used when conducting the base case cost-effectiveness analysis. To estimate the possible variation in unit costs within Europe, other EUnetHTA partners were asked at the beginning of 2012 to estimate the corresponding costs in their countries. The variations in unit costs are reported in this result card (Table 4).

Unit costs were estimated in seven countries and are presented in Table 4 below. The estimates vary greatly from country to country, as could be expected. The estimated costs of pre- and post-operative care, follow-up and overheads, differ between countries (Table 4), and were derived using a variety of methods, as presented in Table 5. Danish and Swedish costs are based on case-mix or micro-costing estimates. Finnish costs are either charges or micro-costing estimates, and Spanish costs are charges or case-mix estimates. Slovakia reported only charges and Croatia only case-mix estimates.

Table 4. Unit costs of relevant resource items in different countries (cost in € except for Sweden [SEK]. Blank: no response). The estimates include: 1pre-operative care; 2post-operative care; 3follow-up; 4overhead costs/fixed costs

 

Denmark

Latvia

Sweden (SEK)

Croatia

Slovakia

Finland

Spain

England

Ireland

Invitation to screening

 

0

   

6

 

n/a

1.50

Ultrasound examination for AAA screening

275 1, 4

35

1404

  

604

37.15

n/a

185

Ultrasound examination for follow-up

275 3, 4

35

140 3

 

50 3, 4

904

37.15

n/a

185

Computer tomography for follow-up after AAA surgery

0

215

8000 3

 

150 3, 4

2354

255.08

n/a

600

Elective open surgery for AAA

2656 1, 2, 3, 4

2250-3200

132000

5500

1000 1, 2, 4

16300 1, 2, 4

10243.834

n/a

20000

Elective endovascular surgery for AAA

2332 1, 2, 4

10000-17000

132000

5500

1500 1, 2, 4

16200 1, 2, 4

4944.31 4

n/a

24000

Emergency surgery for ruptured AAA

3454 1, 2, 3, 4

2250-3200

220000

5500

5000 1, 2, 4

26900 1, 2, 4

12666.97 4

n/a

 

Table 5. The methods used to estimate the unit costs reported in Table 4.

 

Charge /tariff

Recommended price

Case-mix (e.g.DRG)

Micro-costing

Invitation to screening

England

  

Denmark

Ireland

Sweden

Ultrasound examination for AAA screening

England

Finland

Ireland

Spain

Sweden

 

Denmark

Ultrasound examination for follow-up

England

Ireland

Slovakia

Finland

Spain

 

Denmark

Sweden

 

Computer tomography for follow-up after AAA surgery

Slovakia

Finland

Ireland

Spain

 

Denmark

Sweden

 

Elective open surgery for AAA

Slovakia

 

Sweden

Croatia

Ireland

Spain

Denmark

Finland

Elective endovascular surgery for AAA

Slovakia

 

Denmark

Sweden

Croatia

Ireland

Spain

Finland

Emergency surgery for ruptured AAA

Slovakia

 

Sweden

Croatia

Spain

Denmark

Finland


Estimates of the relevant unit costs were obtained in a survey sent to EUnetHTA partners in December 2011 (with reminders in 2012). One should be careful when comparing these figures since we did not ask the respondents to report systematically from which year the cost estimates were derived, or what was the source/reference for the costs. In addition, there is little information about the costs of invitation to screening. This cost may vary depending on the way the invitation process is (and can be) organised in a country. Possible costs associated with, e.g., awareness campaigns concerning population-based screening, should also be included.

Critical
Partially
Mäklin S et al. Result Card ECO3 In: Mäklin S et al. Costs and economic evaluation In: Jefferson T, Vicari N, Frønsdal K [eds.]. Abdominal Aorta Aneurysm Screening [Core HTA], Agenzia nationale per i servizi sanitari regionali (age.na.s), Italy; 2013. [cited 28 May 2023]. Available from: http://corehta.info/ViewCover.aspx?id=106