Cost-Effectiveness of Adjunctive Middle Meningeal Artery Embolization for Chronic Subdural Hematoma: Secondary Analysis of EMBOLISE.
Matthew C Findlay, Gurpreet S Gandhoke, Jason M Davies et al.
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In 30 seconds
This secondary analysis of the EMBOLISE randomized trial evaluated the cost-effectiveness of adjunctive middle meningeal artery embolization (MMAE) versus evacuation surgery (ES) alone in 42 patients with chronic subdural hematoma (cSDH). The study found that ES/MMAE had a mean cost of $23,809 with a 4.1% recurrence rate, compared to $17,197 and 11.3% for ES alone, resulting in an incremental cost-effectiveness ratio of approximately $382,267.50/QALY.
Key findings
- Mean expected costs were $23,809 for ES/MMAE and $17,197 for ES alone.
- The recurrence rate was 4.1% for ES/MMAE compared to 11.3% for ES alone.
- The incremental cost-effectiveness ratio was approximately $382,267.50/QALY.
- There was a 31.8% probability of ES/MMAE being cost-effective at $100,000/QALY.
Why it matters
Understanding the cost-effectiveness of adjunctive treatments like MMAE is crucial for clinicians making decisions about managing cSDH, especially given the high recurrence rates associated with standard evacuation surgery.