cost-utility analysis of carotid artery angioplasty and carotid endarterectomy in iran

Background: carotid artery stenting (cas) and carotid endarterectomy (cea) are two standard methods for the prevention and treatment of cerebrovascular accidents.objectives: this study compared these two methods using an economic evaluation analysis.methods: one hundred patients with carotid occlusive disease at razi hospital in rasht, iran, were analyzed in a retrospective cost-utility study using the sf-12 questionnaire to calculate quality-adjusted life year (qaly) and costs from a societal perspective. this study employed monte carlo simulation and sensitivity analysis for data analysis.results: of the 100 patients, 61 were male, and 64 underwent cea treatment. the incremental cost-effectiveness ratio (icer) of cas versus cea was us$ 213.6 (± 111.2). the icer increased to us$ 1625.6 when governmental currency exchange subsidies were excluded from the cost calculations of the two methods.conclusions: both the costs and qaly of cas are higher than those of cea. the cas is cost-effective when the preferred currency rate is applied to medical equipment pricing [compared to the willingness to pay (wtp) threshold of us$ 1431.85]. however, it is not cost-effective when government subsidies are removed.