Cost–Benefit Analysis Of Modern Endovascular Technologies In Hospital Financial Management

Abstract

Modern endovascular technologies—such as drug-eluting and bioresorbable stents, endovascular aneurysm repair (EVAR) devices, mechanical thrombectomy systems, and advanced imaging-guided catheters—have transformed the management of cardiovascular and neurovascular disease. While these technologies often improve clinical outcomes, shorten hospital stays, and expand minimally invasive options for high-risk patients, their high acquisition and maintenance costs pose major challenges for hospital financial management. This paper examines the cost–benefit profile of contemporary endovascular technologies from the hospital perspective. It explores direct and indirect cost components, revenue implications, and strategic financial considerations such as case-mix optimization, reimbursement dynamics, and capital budgeting. Conceptual and methodological issues in conducting cost–benefit analysis (CBA) are discussed, including cost-effectiveness, cost-utility, and budget impact evaluation, and how these analytic frameworks can be integrated into routine decision-making by hospital management. Illustrative examples include the evaluation of EVAR versus open surgical repair, endovascular therapy for acute ischemic stroke, and peripheral arterial interventions. The discussion highlights how early investment in high-value technologies, when combined with appropriate patient selection, standardised clinical pathways, and data-driven performance monitoring, can produce favourable financial and clinical outcomes. Conversely, uncritical adoption without robust evaluation can lead to cost escalation and inefficient resource use. The paper concludes with recommendations for hospital administrators, clinicians, and policy makers on designing governance structures, information systems, and multidisciplinary committees that systematically assess the value of endovascular technologies and align them with sustainable hospital financial strategies.