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Cost effectiveness of endoscopic ultrasonography, magnetic resonance cholangiopancreatography, and endoscopic retrograde cholangiopancreatography in patients suspected for pancreaticobiliary disease



Cost effectiveness of endoscopic ultrasonography, magnetic resonance cholangiopancreatography, and endoscopic retrograde cholangiopancreatography in patients suspected for pancreaticobiliary disease



Digestive Disease Week Abstracts & Itinerary Planner : Abstract No T1320



Purpose of study: To estimate whether magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasonography (EUS) are more cost-effective than endoscopic retrograde cholangiopancreatography (ERCP) in patients suspected for pancreatobiliary disease. Methods: A cost-effectiveness analysis of the mentioned investigations was performed for 163 patients scheduled for ERCP. Effectiveness of an investigation was defined as the percentage of patients with no need for further therapy after the investigation in question had been performed. Costs were assumed only for the budget holder's point of view. Results: The accuracy for MRCP, EUS, and ERCP were 0.91, 0.93, and 0.92, respectively. Eighty-four (52%) patients were considered to have had need for endoscopic therapeutic procedures in combination with ERCP. The effectiveness of MRCP, EUS, and ERCP were then 0.44, 0.45, and 0,92, respectively. In total 17 (10%) patients had complications following ERCP. The mean hospitalization after ERCP-related complications was 4 days (range 3 to 39 days). The costs of MRCP, EUS, and ERCP in Danish Kroner (DKK) were: 2914, 3309, and 3907, respectively. The cost-effectiveness for MRCP, EUS, and ERCP were correspondingly 6622, 7353, and 4246 DKK per fully examined patient. Conclusion: In a patient population with a probability of having need for therapeutic ERCP in around 50% of the patients, ERCP was more cost-effective than MRCP/EUS.

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Accession: 034658000

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