Controlled trials support pancreatic-stent placement.
Dr Ananya Das and colleagues from Ohio, USA aimed to identify an effective intervention for the prevention of post-ERCP acute pancreatitis in high-risk patients.
The team performed a decision analysis to evaluate the most cost-effective strategy for preventing post-ERCP pancreatitis.
|Stent placement yielded the highest number of years of life|
The research team evaluated 3 competing strategies in a decision analysis model from a third-party-payer perspective in hypothetical patients undergoing ERCP.
The team reported that in strategy 1, none of the patients had pancreatic-stent placement.
Strategy 2 included only those patients identified to be at high risk for post-ERCP, and, in strategy 3, all patients underwent prophylactic stent placement.
Probabilities of developing post-ERCP pancreatitis, and the risk reduction by placement of a pancreatic stent were obtained from published information.
Cost estimates were obtained from Medicare reimbursement rates.
The researchers found that strategy 1 was the least-expensive strategy but yielded the least number of life years.
Strategy 2 yielded the highest number of years of life, with $11,766 per year of life saved, and strategy 3 was dominated by strategy 2.
The team reported that indirect costs and pharmacologic prophylaxis were not considered in this analysis.
Dr Das' team concluded, "Pancreatic-stent placement for the prevention of post-ERCP pancreatitis in high-risk patients is a cost-effective strategy."