Cost-effectiveness comparative analysis of WEB device versus stent-assisted coiling for intracranial unruptured wide-neck aneurysms

HE Chuan; WANG Chunlu; YU Baorong; SHI Huaizhang

doi:10.13798/j.issn.1009-153X.2025.10.004

Abstract：Objective Based on real-world clinical data from the Chinese population and from the perspective of the Chinese healthcare system,this study compares the long-term health outcomes and economic outputs of the Woven Endo-Bridge(WEB)device versus stent-assisted coiling(SAC)for the treatment of intracranial unruptured wide-neck aneurysms.Methods A patient-level simulation study was conducted,enrolling patients with intracranial unruptured wide-neck aneurysms(mean age 61 years,diameter 4～10 mm).The simulation assessed the performance of the WEB treatment strategy versus the SAC strategy in terms of initial treatment efficacy,follow-up outcomes,retreatment needs,and associated costs for rehabilitation and management of hemorrhagic/ischemic events.The incremental cost-effectiveness ratio(ICER)was calculated to evaluate the cost per additional quality-adjusted life year(QALY)gained.Deterministic and probabilistic sensitivity analyses were performed to explore the impact of model parameters on the results.Results The base-case analysis showed that,compared with the SAC strategy,the WEB strategy saved CNY 12 476.52 in lifetime treatment costs and provided an additional 0.97 QALYs,making it a dominant treatment strategy(negative ICER).Deterministic sensitivity analysis indicated that material costs,their quantities,and the complete occlusion rate at initial treatment were key factors influencing the ICER.Conclusion The WEB device demon-strates economic advantages over SAC in the treatment of intracranial unruptured wide-neck aneurysms.The WEB device is a cost-effective treatment option.It is recommended that decision-making consider potential influences from patient preferences,treatment protocols,changes in material prices,and the technical learning curve.