title: Cost disparity between open repair and endovascular aneurysm repair for abdominal aortic aneurysm: a single-institute experience in Japan.
abstract: OBJECTIVE
  We conducted this study to compare the cost of open surgical repair (OR) with that of endovascular aneurysm repair (EVAR) of an abdominal aortic aneurysm (AAA).
  
  
  METHODS
  Between January 2007 and November 2008, 70 patients underwent open repair and 57 patients underwent EVAR. We evaluated the total cost, including that of the Diagnosis Procedure Combination (DPC), that of the surgical procedure, that of materials such as grafts and guide wires, and that of the anesthesia.
  
  
  RESULTS
  The mean costs for OR versus EVAR were as follows: DPC, ¥632,370 versus ¥490,050, respectively, which was significant; anesthesia, ¥123,540 versus ¥86,220, respectively (P < 0.05); and materials, ¥257,770 versus ¥2,113,280, respectively (P < 0.05). Thus, the mean total cost was ¥1,825,830 versus ¥3,159,270 for open repair and EVAR, respectively (P < 0.05).
  
  
  CONCLUSIONS
  New technologies should not only be clinically effective, but also cost effective. EVAR is less invasive clinically, but the cost of endovascular prostheses and other materials remains high.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan. hmorimae@med.nagoya-u.ac.jp
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Morimae
authors.forename: Takashi
authors.initials: T
authors.lastname: Maekawa
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Tamai
authors.forename: Noriko
authors.initials: N
authors.lastname: Takahashi
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Ihara
authors.forename: Akihiko
authors.initials: A
authors.lastname: Hori
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Narita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Banno
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Kiyohito
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Kimihiro
authors.initials: K
authors.lastname: Komori
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000191:economics / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000191:economics* / Q000379:methods; D003362:Cost-Benefit Analysis; D057510:Endovascular Procedures / Q000191:economics* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007813:Laparotomy / Q000191:economics* / Q000379:methods; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
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