Cirrhosis of the liver can be associated with complications, such as acute variceal bleeding and refractory ascites, which can be life-threatening and/or result in substantial healthcare costs.

The economic impact of the use of TIPSS within these two indications has been estimated previously for a UK setting; however, the cost and health impact within a Spanish setting are not well established.

The aims of this study were to estimate the health and cost impact of using TIPSS as a treatment for refractory ascites and as a pre-emptive treatment in people with acute variceal bleeding.

TIPSS is cost-effective for people with acute variceal bleeding and refractory ascites (incremental cost and QALYs of €230 and 0.21 QALYs in acute variceal bleeding; incremental costs and QALYs of €25,687 and 0.53 QALYs in refractory ascites).

The use of TIPSS is associated with health gains and cost savings for both indications considered. This is attributable to resource savings from events such as avoided hospital attendance and reduced adverse events.