Cost-effectiveness of ventriculoperitoneal shunting versus endoscopic third ventriculostomy in the treatment of hydrocephalus

Abstract

Objective. Review of cost-effectiveness studies of ventriculoperitoneal shunting (VPS) and endoscopic third ventriculostomy (EVS) in the treatment of hydrocephalus in children younger than 18 years. Material and methods. The authors summarized the studies devoted to economic evaluation of EVS and VPS in the treatment of hy-drocephalus in children. Studies were searched in the PubMed database. The review includes 3 trials. Results. The studies were carried out in different countries and differ in design. In 2 studies, no significant differences were found in costs of EVS and VPS. In the third study, VPS was more expensive due to length of hospital stay, and EVS had a lower cost-ef-fectiveness ratio compared to VPS ($ 94.797 and 130.839, respectively) but not among patients with myelomeningocele and post-hemorrhagic hydrocephalus. Incremental cost-effectiveness ratios were calculated in none of the studies. No studies were found in Central Asia including Uzbekistan. Conclusion. A review of economic studies of hydrocephalus management revealed insufficient evidence to support cost-effec-tiveness of EVS or VPS.