title: Economic evaluation of MARS--preliminary results on survival and quality of life.
abstract: OBJECTIVE
  The short-term medical benefit of the liver dialysis system MARS in patients with severe acute liver disease has clearly been demonstrated. An economic analysis of MARS has not been presented previously. Objective of the study is to calculate the costs per life saved and life year gained and to measure health related quality of life in patients who survived acute liver failure. First results on survival and HRQL are presented here.
  
  
  METHODS
  Cost effectiveness and cost utility analysis of MARS are performed. All patients since 1993 with chronic liver failure (Bilirubin > 300 micro mol/l) of the university hospital Rostock are included in the original sample (n = 141). Survival data are calculated. Surviving patients were contacted personally, thus quality of life data (EQ 5D and SF12) determined. Patients were compared in case control study design. In a later stage inpatient hospital costs, direct and indirect outpatients costs are included in the analysis.
  
  
  RESULTS
  MARS-Patients show a higher survival: Kaplan-Meier cumulative survival after 100 days: 0.59 after MARS, 0.39 without (P <0.05). There was no significant difference in health related quality of life (SF12 and EQ-D). Calculations of quality adjusted life years (QALYs) result in 0.116 QALYs gained by treatment of one patient with MARS in one year.
  
  
  CONCLUSIONS
  First preliminary results suggest that 1 year after therapy MARS seems to have a positive effect concerning survival rate, survival time and QALYs gained. Final results of cost-effectiveness and cost-utility analysis will soon be presented.
authors.affiliation: Institute for Health Care Management, University of Greifswald, Germany. hessel@uni-greifswald.de
authors.forename: Franz P
authors.initials: FP
authors.lastname: Hessel
authors.forename: Steffen R
authors.initials: SR
authors.lastname: Mitzner
authors.forename: Jana
authors.initials: J
authors.lastname: Rief
authors.forename: Stefan
authors.initials: S
authors.lastname: Gress
authors.forename: Britta
authors.initials: B
authors.lastname: Guellstorff
authors.forename: Jürgen
authors.initials: J
authors.lastname: Wasem
mesh_terms: D000328:Adult; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D017114:Liver Failure, Acute / Q000191:economics / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D006435:Renal Dialysis / Q000191:economics / Q000401:mortality*; D012189:Retrospective Studies; D016060:Sorption Detoxification / Q000191:economics / Q000401:mortality*; D016019:Survival Analysis