Cost-effectiveness analysis of a non-invasive screening strategy in diagnosis of varices for patients with liver cirrhosis

Current guidelines in the UK recommend that all cirrhotic patients should be screen at diagnosis for varices, with follow up every 2-3 years for patients without varices and 1-2 yearly for patients with small varices, to assess for enlargement and need of prophylactic treatment. We investigate the cost-effectiveness of a non-invasive screening compared to endoscopy (EGD) in diagnosis of varices for patients with liver cirrhosis.


Improving the delivery of urgent and emergency care (UEC) services in London is a main priority of NHS England London. To this aim, NHS England London has implemented the Patient Relationship Manager (PRM) system, a Cloud-based clinical record system, designed to improve patient care by information sharing. It works by assisting in directing NHS 111 calls to the most appropriate health care professional depending on the nature of the call. The economic analysis of the PRM aims to estimate the incremental cost of the service and the potential benefit in economic terms. The expected benefits of the PRM from an economic perspective are the operational efficiencies for both integrated Urgent Care Services, and the wider urgent and emergency care networks. These may translate in changes in the use of Urgent Care Services and the potential saving for the NHS.

STROKE- Economic evaluation of stroke treatment

Every year, 15 million people worldwide suffer a stroke. Nearly 6 million die and another 5 million are left permanently disabled. For acute ischemic stroke, intravenous recombinant plasminogen activator (IV-tPA) has demonstrated efficacy and cost-effectiveness when administer to eligible patients. However, the prognosis for patients remains disappointing in part because IV-tPA alone is often unable to achieve recanalization, especially when there is a major vessel occlusion. In this case, there is increasing evidence that mechanical thrombectomy has the potential to improve recanalization rates and outcomes for patients with ischemic stroke. We use a Markov model to model the lifetime cost-utility of mechanical thrombectomy compared to IV-tPA alone in the UK and Italy.

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