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Health gains, costs and cost-effectiveness of a population-based screening programme for abdominal aortic aneurysms

N Nair1, G Kvizhinadze1, G T Jones2

  • 1Burden of Disease Epidemiology, Equity and Cost-Effectiveness Programme (BODE3), Department of Public Health, University of Otago, Wellington, New Zealand.

The British Journal of Surgery
|May 23, 2019
PubMed

Insights

Implementing a UK-style abdominal aortic aneurysm (AAA) screening program in New Zealand is cost-effective. This approach offers significant health gains, making it a valuable public health strategy for older men.

Area of Science:

  • Public Health
  • Health Economics
  • Vascular Surgery

Background:

  • Abdominal aortic aneurysm (AAA) rupture has a high fatality rate.
  • Population-based AAA screening in older men, like in the UK and Sweden, reduces mortality.
  • New Zealand currently lacks a national AAA screening program.

Purpose of the Study:

  • To assess the cost-effectiveness of a UK-style AAA screening program within the New Zealand healthcare system.
  • To evaluate the potential health gains and costs associated with implementing such a program.

Main Methods:

  • A cost-utility analysis was conducted using a Markov macrosimulation model.
  • The model was adapted with New Zealand-specific data to estimate quality-adjusted life-years (QALYs) and costs.
  • A lifetime horizon and a health system perspective were adopted for the analysis.

Main Results:

  • The estimated cost per QALY gained was NZ$15,300 (95% UI: NZ$8,700–$31,000).
  • The program is projected to yield 117 QALYs (95% UI: 53–212) with total health system costs of NZ$1.68 million (95% UI: NZ$820,200–$3.24 million).

Conclusions:

  • A UK-style AAA screening program is projected to be cost-effective in New Zealand.
  • The cost per QALY gained falls below New Zealand's GDP per capita threshold, supporting its implementation.
Abstract

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