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Pancreatic-stent placement for prevention of post-ERCP pancreatitis: a cost-effectiveness analysis.
Gastrointest Endosc 2007; 65(7):960-8GE

Abstract

BACKGROUND

Controlled trials support pancreatic-stent placement as an effective intervention for the prevention of post-ERCP acute pancreatitis in high-risk patients.

OBJECTIVE

To perform a decision analysis to evaluate the most cost-effective strategy for preventing post-ERCP pancreatitis.

DESIGN

Cost-effectiveness analysis.

SETTING

Patients undergoing ERCP.

INTERVENTIONS

Three competing strategies were evaluated in a decision analysis model from a third-party-payer perspective in hypothetical patients undergoing ERCP. In strategy I, none of the patients had pancreatic-stent placement. Strategy II had only those patients identified to be at high risk for post-ERCP, and, in strategy III, all patients underwent prophylactic stent placement. Probabilities of developing post-ERCP pancreatitis and the risk reduction by placement of a pancreatic stent were obtained from published information. Cost estimates were obtained from Medicare reimbursement rates.

MAIN OUTCOME MEASUREMENTS

Incremental cost-effectiveness ratio (ICER) of different strategies.

RESULTS

Strategy I was the least-expensive strategy but yielded the least number of life years. Strategy II yielded the highest number of years of life, with an ICER of $11,766 per year of life saved, and strategy III was dominated by strategy II.

LIMITATIONS

Indirect costs and pharmacologic prophylaxis were not considered in this analysis.

CONCLUSIONS

Pancreatic-stent placement for the prevention of post-ERCP pancreatitis in high-risk patients is a cost-effective strategy.

Authors+Show Affiliations

Division of Gastroenterology, Mayo Clinic Scottsdale, Scottsdale, Arizona 85259, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17331513

Citation

Das, Ananya, et al. "Pancreatic-stent Placement for Prevention of post-ERCP Pancreatitis: a Cost-effectiveness Analysis." Gastrointestinal Endoscopy, vol. 65, no. 7, 2007, pp. 960-8.
Das A, Singh P, Sivak MV, et al. Pancreatic-stent placement for prevention of post-ERCP pancreatitis: a cost-effectiveness analysis. Gastrointest Endosc. 2007;65(7):960-8.
Das, A., Singh, P., Sivak, M. V., & Chak, A. (2007). Pancreatic-stent placement for prevention of post-ERCP pancreatitis: a cost-effectiveness analysis. Gastrointestinal Endoscopy, 65(7), pp. 960-8.
Das A, et al. Pancreatic-stent Placement for Prevention of post-ERCP Pancreatitis: a Cost-effectiveness Analysis. Gastrointest Endosc. 2007;65(7):960-8. PubMed PMID: 17331513.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pancreatic-stent placement for prevention of post-ERCP pancreatitis: a cost-effectiveness analysis. AU - Das,Ananya, AU - Singh,Pankaj, AU - Sivak,Michael V,Jr AU - Chak,Amitabh, Y1 - 2007/02/28/ PY - 2006/01/16/received PY - 2006/07/17/accepted PY - 2007/3/3/pubmed PY - 2007/7/27/medline PY - 2007/3/3/entrez SP - 960 EP - 8 JF - Gastrointestinal endoscopy JO - Gastrointest. Endosc. VL - 65 IS - 7 N2 - BACKGROUND: Controlled trials support pancreatic-stent placement as an effective intervention for the prevention of post-ERCP acute pancreatitis in high-risk patients. OBJECTIVE: To perform a decision analysis to evaluate the most cost-effective strategy for preventing post-ERCP pancreatitis. DESIGN: Cost-effectiveness analysis. SETTING: Patients undergoing ERCP. INTERVENTIONS: Three competing strategies were evaluated in a decision analysis model from a third-party-payer perspective in hypothetical patients undergoing ERCP. In strategy I, none of the patients had pancreatic-stent placement. Strategy II had only those patients identified to be at high risk for post-ERCP, and, in strategy III, all patients underwent prophylactic stent placement. Probabilities of developing post-ERCP pancreatitis and the risk reduction by placement of a pancreatic stent were obtained from published information. Cost estimates were obtained from Medicare reimbursement rates. MAIN OUTCOME MEASUREMENTS: Incremental cost-effectiveness ratio (ICER) of different strategies. RESULTS: Strategy I was the least-expensive strategy but yielded the least number of life years. Strategy II yielded the highest number of years of life, with an ICER of $11,766 per year of life saved, and strategy III was dominated by strategy II. LIMITATIONS: Indirect costs and pharmacologic prophylaxis were not considered in this analysis. CONCLUSIONS: Pancreatic-stent placement for the prevention of post-ERCP pancreatitis in high-risk patients is a cost-effective strategy. SN - 0016-5107 UR - https://www.unboundmedicine.com/medline/citation/17331513/Pancreatic_stent_placement_for_prevention_of_post_ERCP_pancreatitis:_a_cost_effectiveness_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(06)02493-X DB - PRIME DP - Unbound Medicine ER -