Cost of treatment of oesophageal variceal bleeding in patients with cirrhosis in France: results of a French survey.

Objective: To estimate the costs to treat oesophageal variceal bleeding in patients with cirrhosis in France from a hospital perspective.
Methods: A model was developed to present the current treatment pathway of variceal bleeding in France covering 42 days from hospital admission. Input of the model was based on interviews with 10 hepatogastroenterologists geographically spread throughout France. A validated questionnaire was used to collect medical resource-use of the treated patients separated for patients suffering from Child-Pugh class A, B and C liver disease.
Results: Average hospital treatment cost of patients requiring only initial management to stop the bleeding was euro 9906. Costs of patients in whom initial treatment was not successful averaged euro 23,113 and euro 29,406 for patients requiring respectively one or two additional procedures to control the bleeding. On average, the hospital incurred euro 11,134, euro 12,698 and euro 14,168 for class A, B and C patients, respectively.
Conclusions: Management of variceal bleeding is very costly compared with other digestive diseases. In particular, additional treatment needed because of failure to control bleeding or early rebleeding makes the management expensive. The severity of the underlying liver disease has a great impact on treatment outcome, leading to higher treatment costs for class C patients than less affected patients.