Table 2

Resource usage, unit and total costs (2017/2018 prices) and utilities

TIPSS procedure
 TIPSS procedure plus consumables1.00£2353KOLs; Gore
 Diagnostic tests (elective only)3.13£396KOLs22
 Pre-procedure HCP (hours)0.33£36KOLs24
 Procedure HCP (hours)14.00£796KOLs24
 Hospital stay (elective) days2.00£1064KOLs22
 Hospital stay (non-elective) days5.00£2212KOLs22
Total (elective)£4646
Total (non-elective)£5398
Standard care: indication 1 (variceal bleeding)
 Outpatient EBL (months 1–2)4.00£2177KOLs22
 Outpatient EBL (months 3–24)3.00£1633KOLs22
 Pharmaceuticals (per month)Various£4.4223
Total costs (24 month survival)£3862
Standard care: indication 2 (refractory ascites)
 LVP per procedure
  HCP time (nurse: hours)0.50£19KOLs22
  Human albumin (dose 52 mg)1.00£34KOLs23
  Hospital stay1.90£568KOLs22
 Cost per LVP+human albumin1.00£800
Total cost (24-month survival)52.00£41 618
Total costDisutilitySource (utility)
Cost and disutility per adverse event
TIPSS*Reported above0.01027
Shunt dysfunction*£40950.01027
Variceal bleeding†27
 TIPSS (indications 1 and 2)£,30810.154
 Standard care (indication 1)£64540.154
 Standard care (indication 2)£30810.154
 Uncomplicated, moderate£60.125
 Uncomplicated, large£9600.125
Hepatic Encephalopathy32
 Mild HE (grade I and II)†£910.070
 Severe HE (grade III and IV)†£13770.130
Catheter failure£5520.000‡N/A
  • Cost components and sources are reported in full in online supplemental appendix 3.

  • *Utility decrement applied only to length of hospital stay.

  • †Utility decrement applied to full cycle (monthly per event rate).

  • ‡Utility decrement equal to zero as no published evidence to the contrary.

  • EBL, endoscopic band ligation; HCP, healthcare provider; HE, hepatic encephalopathy; KOL, key opinion leader; LVP, large vol paracentesis; SBP, spontaneous bacterial peritonitis; TIPSS, transjugular intrahepatic stent shunt.