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Ontario Canada Analysis Shows 40% Cost Savings for Endovenous Laser Procedure Versus Vein Stripping

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    Ontario, Canada



    An evidence based analysis for endovenous laser ablation versus traditional vein stripping in the province of Ontario, Canada shows a 40% cost saving in favor of endovenous laser therapy.



    The Ontario Health Technology Advisory Committee (OHTAC) met on November 27, 2009 to review the safety, effectiveness, durability and cost-effectiveness of ELT for the treatment of primary VV based on an evidence-based review by the Medical Advisory Secretariat (MAS).

    The MAS evidence search identified 14 systematic reviews, 29 cohort studies on safety and effectiveness, four cost studies and 12 randomized controlled trials involving ELT, six of these comparing endovascular laser with surgical ligation and saphenous vein stripping.

    The average case cost (based on Ontario hospital costs and medical resources) for surgical vein stripping was estimated to be $1,799. Because of the uncertainties with resources associated with ELT, in addition to the device related costs, hospital costs were varied and assumed to be the same as or less than (40%) those for surgery resulting in an average ELT case cost of $2,025 or $1,602. 

    The authors of this study was Health Quality Ontario.



    This article was published in Ont Health Technol Assess Ser. 2010;10(6). 

    Dr Karamanoukian's notes:  Endovenous laser ablation of the saphenous veins is not a covered procedure in the province of Ontario, Canada. Patients seem to favor this procedure over "traditional vein stripping" and seek care across the border in the United States. It is my profesional opinion and the opinion of the vast majority of vein specialists in the United States, as corroborated by numerous studies in the literature, that endovenous ablation has quicker return to normal daily fucnton, has les associated morbidity and is equally efficacious to vein stripping in treating venous insufficiency. The indices of pain and disability have been shown in numerous studies to be lower and more favorable in the endovenous ablation groups. The Vein Treatment Center welcomes Canadian patients who seek endovenous ablation in the United states.