Radiofrequency ablation vs conventional surgery for varicose veins - a comparison of treatment costs in a randomised trial

Abstract

Objective: To compare the costs involved (from procedure to recovery) following radiofrequency ablation and conventional surgery for lower limb varicose veins in a selected population.

Design: Prospective randomised controlled trial.

Methods: Patients with symptomatic great saphenous varicose veins suitable for radiofrequency ablation were randomised to either RF ablation or surgery (sapheno-femoral ligation and stripping). The hospital, general practice and patient costs incurred until full recovery and the indirect cost to society, due to sickness leave after surgery, were calculated to indicate mean cost per patient under each category.

Results: Ninety three patients were randomised. Eighty eight patients (47 - RF ablation, 41 - surgery) underwent the allocated intervention. Ablation took longer to perform than surgery (mean 76.8 vs 47.0 min, p<.001). Ablation was more expensive (mean hospital cost per patient 1275.90 pounds vs 559.13 pounds) but enabled patients to return to work 1 week earlier than after surgery (mean 12.2 vs 19.8 days, p=0.006). Based on the Annual Survey of Hours and Earnings (Office of National Statistics, UK) for full time employees, the cost per working hour gained after ablation was 6.94 pounds (95% CI 6.26, 7.62).

Conclusion: The increased cost of radiofrequency ablation is partly offset by a quicker return to work in the employed group (ISRCTN29015169http://www.controlled-trials.com).