title: Cost-Effectiveness Analysis of Percutaneous Sclerotherapy for Venous Malformations.
abstract: OBJECTIVE
  To assess cost-effectiveness of sclerotherapy for venous malformations (VMs) to improve patient quality of life (QOL).
  
  
  METHODS
  This prospective study enrolled 28 patients with symptomatic VMs who underwent sclerotherapy. EuroQol-5 Dimension (EQ-5D) and Short-Form 36 (SF-36) Health Survey were used to measure health-related QOL. Questionnaires were collected before and 1, 3, 6, and 12 months after sclerotherapy. Quality-adjusted life years (QALYs) were calculated using EQ-5D score as a measure of health utility. Medical costs obtained from the hospital accounting system and other costs of staff, drugs, materials, and angiographic equipment were calculated for each procedure. Cost-effectiveness was analyzed using incremental cost-effectiveness ratio (ICER) as the medical cost/gain of QALYs.
  
  
  RESULTS
  Median EQ-5D scores improved from 0.768 (range, 0.705-1) to 1 (range, 0.768-1) after 6 months (P = .023) and 1 (range, 0.768-1) after 12 months (P = .063). The gain of QALYs at 12 months was 0.043. The mean medical cost was ¥281,228 ($2,337). The pain group (baseline bodily pain scale of SF-36 score < 70) showed greater improvement in median EQ-5D score, from 0.705 (range, 0.661-0.768) to 0.768 (range, 0.705-1) after 6 months (P = .041) and 0.768 (range, 0.768-1) after 12 months (P = .049). ICER at 12 months was ¥6,600,483 ($54,840) in the overall group and decreased to ¥3,998,113 ($33,218) in the pain group, < ¥6,000,000 ($49,850), threshold for acceptance of a public health benefit in Japan, even accounting for 50% increase in costs.
  
  
  CONCLUSIONS
  Sclerotherapy was cost-effective for improving QOL for symptomatic VMs, especially for patients with moderate to severe pain.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan. Electronic address: y-ono@radiol.med.osaka-u.ac.jp.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ono
authors.affiliation: Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
authors.forename: Keigo
authors.initials: K
authors.lastname: Osuga
authors.affiliation: Department of Health Care Economics and Industrial Policy, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Takura
authors.affiliation: Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
authors.forename: Masahisa
authors.initials: M
authors.lastname: Nakamura
authors.affiliation: Department of Diagnostic Radiology 2, Kawasaki Hospital, Kawasaki Medical School, Okayama, Okayama, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Shibamoto
authors.affiliation: Department of Diagnostic Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Yamamoto
authors.affiliation: Department of Radiology, Okayama University Medical School, Okayama, Okayama, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Fujiwara
authors.affiliation: Department of Radiology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Mimura
authors.affiliation: Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Tomiyama
mesh_terms: D000293:Adolescent; D000328:Adult; D001165:Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000191:economics* / Q000628:therapy*; D002648:Child; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007564:Japan; D018810:Magnetic Resonance Angiography / Q000191:economics; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D011446:Prospective Studies; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012597:Sclerosing Solutions / Q000008:administration & dosage* / Q000009:adverse effects; D015911:Sclerotherapy / Q000009:adverse effects / Q000379:methods*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014680:Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging; D055815:Young Adult
chemical_list: D012597:Sclerosing Solutions