Cirrhosis cost-effectiveness of therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-In-Chief: Ujjwal Rastogi, M.B.B.S. [2]


According to a report from The National Center for Health Statistics, cirrhosis and chronic liver disease accounted for more than 25,000 deaths and 373,000 hospital discharges in the United States in 1998.[1] Therefore, cirrhosis and chronic liver disease have a huge financial impact on the health care industry.

Cost-Effectiveness of Therapy

Management of adult patients with ascites due to cirrhosis

Role of TIPS vs distal splenorenal shunt in the management of portal hypertension


A cost-effectiveness analysis of a randomized controlled trial comparing transjugular intrahepatic portosystematic shunt (TIPS) (bare metal Wallstents) to distal splenorenal shunt (DSRS) reported costs of both in- and out-patient care.

  • The average yearly cost over a 5 year period were $16,363 for TIPS patients and $13,492 for the DSRS patients. These yearly costs are similar to what has been reported for pharmacologic and endoscopic management of patients with bleeding varices.
  • TIPS was slightly more cost effective than DSRS at year five ($61,000 per life saved) but the difference was felt to be insignificant. Using covered, rather than bare wall stents, was estimated to increase the cost-effectiveness of TIPS only slightly. The authors conclude that TIPS is as effective as DSRS in the prevention of variceal rebleeding and may be slightly more cost-effective.


  1. Schuppan D, Afdhal NH (2008). "Liver cirrhosis". Lancet. 371 (9615): 838–51. doi:10.1016/S0140-6736(08)60383-9. PMC 2271178. PMID 18328931.