Cost disparity between open repair and endovascular aneurysm repair for abdominal aortic aneurysm: a single-institute experience in Japan

We conducted this study to compare the cost of open surgical repair (OR) with that of endovascular aneurysm repair (EVAR) of an abdominal aortic aneurysm (AAA). Between January 2007 and November 2008, 70 patients underwent open repair and 57 patients underwent EVAR. We evaluated the total cost, including that of the Diagnosis Procedure Combination (DPC), that of the surgical procedure, that of materials such as grafts and guide wires, and that of the anesthesia. The mean costs for OR versus EVAR were as follows: DPC, Ayen632370 versus Ayen490050, respectively, which was significant; anesthesia, Ayen123540 versus Ayen86220, respectively (P < 0.05); and materials, Ayen257770 versus Ayen2113280, respectively (P < 0.05). Thus, the mean total cost was Ayen1825830 versus Ayen3159270 for open repair and EVAR, respectively (P < 0.05). New technologies should not only be clinically effective, but also cost effective. EVAR is less invasive clinically, but the cost of endovascular prostheses and other materials remains high.