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Cost-utility analysis of percutaneous mitral valve repair in inoperable patients with functional mitral regurgitation in German settings.

Borisenko O, Haude M, Hoppe UC, Siminiak T, Lipiecki J, Goldberg SL, Mehta N, Bouknight OV, Bjessmo S, Reuter DG - BMC Cardiovasc Disord (2015)

Bottom Line: However, PMVR provided additional benefits to patients with an 1.15 incremental quality-adjusted life years (QALY) and an 1.41 incremental life years.The percutaneous procedure was cost-effective in comparison to OMT with an incremental cost-effectiveness ratio of €15,533/QALY.In the probabilistic sensitivity analysis with a willingness-to-pay threshold of €35,000/QALY, PMVR had a 84 % probability of being cost-effective.

View Article: PubMed Central - PubMed

Affiliation: Synergus AB, Svardvagen 19, 182 33, Danderyd, Sweden. oleg.borisenko@synergus.com.

ABSTRACT

Background: To determine the cost-effectiveness of the percutaneous mitral valve repair (PMVR) using Carillon® Mitral Contour System® (Cardiac Dimensions Inc., Kirkland, WA, USA) in patients with congestive heart failure accompanied by moderate to severe functional mitral regurgitation (FMR) compared to the prolongation of optimal medical treatment (OMT).

Methods: Cost-utility analysis using a combination of a decision tree and Markov process was performed. The clinical effectiveness was determined based on the results of the Transcatheter Implantation of Carillon Mitral Annuloplasty Device (TITAN) trial. The mean age of the target population was 62 years, 77% of the patients were males, 64% of the patients had severe FMR and all patients had New York Heart Association functional class III. The epidemiological, cost and utility data were derived from the literature. The analysis was performed from the German statutory health insurance perspective over 10-year time horizon.

Results: Over 10 years, the total cost was €36,785 in the PMVR arm and €18,944 in the OMT arm. However, PMVR provided additional benefits to patients with an 1.15 incremental quality-adjusted life years (QALY) and an 1.41 incremental life years. The percutaneous procedure was cost-effective in comparison to OMT with an incremental cost-effectiveness ratio of €15,533/QALY. Results were robust in the deterministic sensitivity analysis. In the probabilistic sensitivity analysis with a willingness-to-pay threshold of €35,000/QALY, PMVR had a 84 % probability of being cost-effective.

Conclusions: Percutaneous mitral valve repair may be cost-effective in inoperable patients with FMR due to heart failure.

No MeSH data available.


Related in: MedlinePlus

Tornado diagram. The Tornado diagram shows the results of the sensitivity analyses on the cost-effectiveness of PMVR compared with optimal medical treatment. The blue lines with a diagonal pattern reflect results while using maximum values in the sensitivity analysis and the orange lines reflect results while using minimum values. The vertical line indicates the base-case incremental cost-effectiveness ratio. PMVR, percutaneous mitral valve repair; QALY, quality-adjusted life year
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Fig3: Tornado diagram. The Tornado diagram shows the results of the sensitivity analyses on the cost-effectiveness of PMVR compared with optimal medical treatment. The blue lines with a diagonal pattern reflect results while using maximum values in the sensitivity analysis and the orange lines reflect results while using minimum values. The vertical line indicates the base-case incremental cost-effectiveness ratio. PMVR, percutaneous mitral valve repair; QALY, quality-adjusted life year

Mentions: The results of the one-way sensitivity analysis were stable with no single variable altering the cost-effectiveness of PMVR (Fig. 3). The most sensitive variables were the cost of the Carillon device, the age of the patient, the probability of unsuccessful annuloplasty and the presence of severe FMR at baseline.Fig. 3


Cost-utility analysis of percutaneous mitral valve repair in inoperable patients with functional mitral regurgitation in German settings.

Borisenko O, Haude M, Hoppe UC, Siminiak T, Lipiecki J, Goldberg SL, Mehta N, Bouknight OV, Bjessmo S, Reuter DG - BMC Cardiovasc Disord (2015)

Tornado diagram. The Tornado diagram shows the results of the sensitivity analyses on the cost-effectiveness of PMVR compared with optimal medical treatment. The blue lines with a diagonal pattern reflect results while using maximum values in the sensitivity analysis and the orange lines reflect results while using minimum values. The vertical line indicates the base-case incremental cost-effectiveness ratio. PMVR, percutaneous mitral valve repair; QALY, quality-adjusted life year
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4443594&req=5

Fig3: Tornado diagram. The Tornado diagram shows the results of the sensitivity analyses on the cost-effectiveness of PMVR compared with optimal medical treatment. The blue lines with a diagonal pattern reflect results while using maximum values in the sensitivity analysis and the orange lines reflect results while using minimum values. The vertical line indicates the base-case incremental cost-effectiveness ratio. PMVR, percutaneous mitral valve repair; QALY, quality-adjusted life year
Mentions: The results of the one-way sensitivity analysis were stable with no single variable altering the cost-effectiveness of PMVR (Fig. 3). The most sensitive variables were the cost of the Carillon device, the age of the patient, the probability of unsuccessful annuloplasty and the presence of severe FMR at baseline.Fig. 3

Bottom Line: However, PMVR provided additional benefits to patients with an 1.15 incremental quality-adjusted life years (QALY) and an 1.41 incremental life years.The percutaneous procedure was cost-effective in comparison to OMT with an incremental cost-effectiveness ratio of €15,533/QALY.In the probabilistic sensitivity analysis with a willingness-to-pay threshold of €35,000/QALY, PMVR had a 84 % probability of being cost-effective.

View Article: PubMed Central - PubMed

Affiliation: Synergus AB, Svardvagen 19, 182 33, Danderyd, Sweden. oleg.borisenko@synergus.com.

ABSTRACT

Background: To determine the cost-effectiveness of the percutaneous mitral valve repair (PMVR) using Carillon® Mitral Contour System® (Cardiac Dimensions Inc., Kirkland, WA, USA) in patients with congestive heart failure accompanied by moderate to severe functional mitral regurgitation (FMR) compared to the prolongation of optimal medical treatment (OMT).

Methods: Cost-utility analysis using a combination of a decision tree and Markov process was performed. The clinical effectiveness was determined based on the results of the Transcatheter Implantation of Carillon Mitral Annuloplasty Device (TITAN) trial. The mean age of the target population was 62 years, 77% of the patients were males, 64% of the patients had severe FMR and all patients had New York Heart Association functional class III. The epidemiological, cost and utility data were derived from the literature. The analysis was performed from the German statutory health insurance perspective over 10-year time horizon.

Results: Over 10 years, the total cost was €36,785 in the PMVR arm and €18,944 in the OMT arm. However, PMVR provided additional benefits to patients with an 1.15 incremental quality-adjusted life years (QALY) and an 1.41 incremental life years. The percutaneous procedure was cost-effective in comparison to OMT with an incremental cost-effectiveness ratio of €15,533/QALY. Results were robust in the deterministic sensitivity analysis. In the probabilistic sensitivity analysis with a willingness-to-pay threshold of €35,000/QALY, PMVR had a 84 % probability of being cost-effective.

Conclusions: Percutaneous mitral valve repair may be cost-effective in inoperable patients with FMR due to heart failure.

No MeSH data available.


Related in: MedlinePlus