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Cost-Effectiveness of Haemorrhoidal Artery Ligation versus Rubber Band Ligation for the Treatment of Grade II–III Haemorrhoids: Analysis Using Evidence from the HubBLe Trial

Abualbishr Alshreef (), Allan J. Wailoo, Steven R. Brown, James P. Tiernan, Angus J. M. Watson, Katie Biggs, Mike Bradburn and Daniel Hind
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Abualbishr Alshreef: University of Sheffield
Allan J. Wailoo: University of Sheffield
Steven R. Brown: Sheffield Teaching Hospitals
James P. Tiernan: St James’s University Hospital
Angus J. M. Watson: Raigmore Hospital
Katie Biggs: University of Sheffield
Mike Bradburn: University of Sheffield
Daniel Hind: University of Sheffield

PharmacoEconomics - Open, 2017, vol. 1, issue 3, 175-184

Abstract: Abstract Aim Haemorrhoids are a common condition, with nearly 30,000 procedures carried out in England in 2014/15, and result in a significant quality-of-life burden to patients and a financial burden to the healthcare system. This study examined the cost effectiveness of haemorrhoidal artery ligation (HAL) compared with rubber band ligation (RBL) in the treatment of grade II–III haemorrhoids. Method This analyses used data from the HubBLe study, a multicentre, open-label, parallel group, randomised controlled trial conducted in 17 acute UK hospitals between September 2012 and August 2015. A full economic evaluation, including long-term cost effectiveness, was conducted from the UK National Health Service (NHS) perspective. Main outcomes included healthcare costs, quality-adjusted life-years (QALYs) and recurrence. Cost-effectiveness results were presented in terms of incremental cost per QALY gained and cost per recurrence avoided. Extrapolation analysis for 3 years beyond the trial follow-up, two subgroup analyses (by grade of haemorrhoids and recurrence following RBL at baseline), and various sensitivity analyses were undertaken. Results In the primary base-case within-trial analysis, the incremental total mean cost per patient for HAL compared with RBL was £1027 (95% confidence interval [CI] £782–£1272, p

Keywords: National Health Service; Probabilistic Sensitivity Analysis; Seemingly Unrelated Regression; Rubber Band Ligation; Electronic Supplementary Material (search for similar items in EconPapers)
Date: 2017
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