Cost-Utility Analysis of Carotid Artery Angioplasty and Carotid Endarterectomy in Iran

Background: Carotid artery stenting (CAS) and carotid endarterectomy (CEA) are two standard methods for the prevention and treatment of cerebrovascular accidents. Objectives: This study compared these two methods using an economic evaluation analysis. Methods: One hundred patients with carotid occl...

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Bibliographic Details
Main Authors: Mohammad Taghi Ashoobi, Sara Zahedfar, Hossein Hemmati, Enayatollah Homaie Rad
Format: Article
Language:English
Published: Tehran University of Medical Sciences 2025-05-01
Series:Health Technology Assessment in Action
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Online Access:https://htainaction.tums.ac.ir/index.php/hta/article/view/310
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Summary:Background: Carotid artery stenting (CAS) and carotid endarterectomy (CEA) are two standard methods for the prevention and treatment of cerebrovascular accidents. Objectives: This study compared these two methods using an economic evaluation analysis. Methods: One hundred patients with carotid occlusive disease at Razi Hospital in Rasht, Iran, were analyzed in a retrospective cost-utility study using the SF-12 Questionnaire to calculate quality-adjusted life year (QALY) and costs from a societal perspective. This study employed Monte Carlo simulation and sensitivity analysis for data analysis. Results: Of the 100 patients, 61 were male, and 64 underwent CEA treatment. The incremental cost-effectiveness ratio (ICER) of CAS versus CEA was US$ 213.6 (± 111.2). The ICER increased to US$ 1625.6 when governmental currency exchange subsidies were excluded from the cost calculations of the two methods. Conclusions: Both the costs and QALY of CAS are higher than those of CEA. The CAS is cost-effective when the preferred currency rate is applied to medical equipment pricing [compared to the willingness to pay (WTP) threshold of US$ 1431.85]. However, it is not cost-effective when government subsidies are removed.
ISSN:2645-3835