The cost-effectiveness of a "quick-screen" program for abdominal aortic aneurysms.

Area of Science:

• Vascular Surgery
• Health Economics
• Diagnostic Imaging

Background:

• Abdominal aortic aneurysm (AAA) incidence is rising, with poor outcomes for ruptured cases.
• Early detection and intervention are critical for improving AAA prognosis.
• This study evaluates the cost-effectiveness of a brief ultrasound screening for AAA.

Purpose of the Study:

• To determine if a brief "quick-screen" ultrasound for abdominal aortic aneurysm (AAA) is cost-effective.
• To compare the time and accuracy of quick-screen ultrasound versus conventional studies.
• To analyze the long-term cost-effectiveness of AAA screening using a Markov model.

Main Methods:

• 25 patients with AAA risk factors underwent blinded quick-screen and conventional ultrasounds.
• Time and accuracy were compared between the two ultrasound methods.
• A Markov model assessed long-term survival (quality-adjusted life years) and costs for screening vs. no screening in 70-year-old males.

Main Results:

• Quick-screen ultrasound averaged one-sixth the time of conventional studies (4 vs. 24 minutes) with 100% accuracy.
• AAA screening was cost-effective with a cost-effectiveness ratio (CER) of $11,215.
• Reducing screening cost to $40 improved CER to $6850; screening higher-prevalence groups further enhanced cost-effectiveness.

Conclusions:

• Ultrasound screening for abdominal aortic aneurysm (AAA) should be offered to all males over 60.
• Widespread AAA screening adoption is recommended.
• Medicare and other insurers should reimburse for AAA screening.