Cost-effectiveness of screening for familial abdominal aortic aneurysms

Background. Screening for familial abdominal aortic aneurysms (AAA) is wide ly recommended. To analyze cost-effectiveness of screening for familial AAA s incremental cost-effectiveness (C/E) analysis based on an ultrasound scre ening among relatives and a decision model of screening program was compare d to a baseline situation without systematic screening. Patients and methods: 74% (238/322) of first-degree relatives of 150 consec utive AAA patients were screened at HUCH (Helsinki University Central Hospi tal). Effectiveness and costs of treatment were assessed using the Finnish Hospital Discharge Register and from survival analysis of 1130 AAA patients who underwent elective or emergency surgery in HUCH. To form incremental C /E-ratios the existing clinical practice was compared to a screening progra m for male siblings. Hypothetical screened and control cohorts of 1000 male relatives were used to create the decision model. Parameters in C/E-analys es were derived from our own data except for growth and rupture rates. A se nsitivity analysis was carried out. Results. The incremental effectiveness in life-years gained by the screenin g of male siblings was 92 years with incremental C/E-ratio of FIM 33 000 ($ 6200). According to sensitivity analysis the C/E-ratios were robust for al l variables tested. Conclusions: Screening of male siblings of AAA patients produces incrementa l life-years at low cost thus screening of male siblings is highly recommen ded.