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Japanese Journal of Radiology

Open Access 25-09-2024 | Hypertension | Original Article

Cost-effectiveness analysis of segmental adrenal venous sampling with radiofrequency ablation for primary aldosteronism in Japan

Authors: Satoru Yanagaki, Kei Omata, Sota Oguro, Hideki Ota, Tomomi Sato, Hiroki Kamada, Hiromitsu Tannai, Yuta Tezuka, Yoshikiyo Ono, Miho Sato, Hiroyuki Ohbe, Kei Takase

Published in: Japanese Journal of Radiology

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Abstract

Purpose

The purpose of this study was to evaluate the cost-effectiveness of comprehensive treatment strategy, including segmental adrenal venous sampling (sAVS) and radiofrequency ablation (RFA), versus medication-only strategy for primary aldosteronism.

Materials and methods

A Markov decision model was developed to compare the cost-effectiveness of a comprehensive treatment strategy and a medication-only strategy for 50-year-old men and women with stage I–III hypertension. The comprehensive treatment strategy included aldosterone/renin ratio measurement, two loading tests, computed tomography, sAVS, drugs, surgery, and RFA. We built a model with a yearly cycle over 32- and 38-year time horizons for men and women, respectively, and four health states: hypertension, heart failure, stroke, and death. The incremental cost-effectiveness ratio (ICER), expressed as Japanese yen per quality-adjusted life-years (QALYs), was estimated, and strategy preference was determined on the basis of 5 million Japanese yen per QALY societal willingness-to-pay threshold.

Results

The ICERs of the comprehensive treatment strategy over the medication-only strategy were 201,482 and 3,399 JPY per QALY for men and women, respectively. The resultant ICER was less than the 5 million JPY societal willingness-to-pay threshold. Deterministic sensitivity analysis and probabilistic sensitivity analysis revealed that the results varied with the input values, but the comprehensive strategy was likely to be more cost-effective than the medication-only strategy.

Conclusion

This cost-effectiveness study revealed that a comprehensive treatment strategy including sAVS and RFA was favorable compared with the medication-only strategy for managing stage I–III hypertension in 50-year-old men and women, with acceptable willingness-to-pay thresholds.

Secondary abstract

This cost-effectiveness study revealed that a comprehensive treatment strategy for primary aldosteronism that included segmental adrenal sampling and radiofrequency ablation was favorable compared with the medication-only strategy for managing stage I–III hypertension in 50-year-old men and women, with acceptable willingness-to-pay thresholds.
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Metadata
Title
Cost-effectiveness analysis of segmental adrenal venous sampling with radiofrequency ablation for primary aldosteronism in Japan
Authors
Satoru Yanagaki
Kei Omata
Sota Oguro
Hideki Ota
Tomomi Sato
Hiroki Kamada
Hiromitsu Tannai
Yuta Tezuka
Yoshikiyo Ono
Miho Sato
Hiroyuki Ohbe
Kei Takase
Publication date
25-09-2024
Publisher
Springer Nature Singapore
Published in
Japanese Journal of Radiology
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI
https://doi.org/10.1007/s11604-024-01665-6