Cost-effectiveness analysis of leadless cardiac resynchronization therapy.
biventricular pacing/defibrillation
pacemaker-bradyarrhythmias
Journal
Journal of cardiovascular electrophysiology
ISSN: 1540-8167
Titre abrégé: J Cardiovasc Electrophysiol
Pays: United States
ID NLM: 9010756
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
revised:
11
09
2023
received:
14
07
2023
accepted:
30
09
2023
medline:
11
12
2023
pubmed:
10
10
2023
entrez:
10
10
2023
Statut:
ppublish
Résumé
The Wireless Stimulation Endocardially for CRT (WiSE-CRT) system is a novel technology used to treat patients with dyssynchronous heart failure (HF) by providing leadless cardiac resynchronization therapy (CRT). Observational studies have demonstrated its safety and efficacy profile, however, the treatment cost-effectiveness has not previously been examined. A cost-effectiveness evaluation of the WiSE-CRT System was performed using a cohort-based economic model adopting a "proportion in state" structure. In addition to the primary analysis, scenario analyses and sensitivity analyses were performed to test for uncertainty in input parameters. Outcomes were quantified in terms of quality-adjusted life year (QALY) differences. The primary analysis demonstrated that treatment with the WiSE-CRT system is likely to be cost-effective over a lifetime horizon at a QALY reimbursement threshold of £20 000, with a net monetary benefit (NMB) of £3781 per QALY. Cost-effectiveness declines at time horizons shorter than 10 years. Sensitivity analyses demonstrated that average system battery life had the largest impact on potential cost-effectiveness. Within the model limitations, these findings support the use of WiSE-CRT in indicated patients from an economic standpoint. However, improving battery technology should be prioritized to maximize cost-effectiveness in times when health services are under significant financial pressures.
Sections du résumé
BACKGROUND
BACKGROUND
The Wireless Stimulation Endocardially for CRT (WiSE-CRT) system is a novel technology used to treat patients with dyssynchronous heart failure (HF) by providing leadless cardiac resynchronization therapy (CRT). Observational studies have demonstrated its safety and efficacy profile, however, the treatment cost-effectiveness has not previously been examined.
METHODS
METHODS
A cost-effectiveness evaluation of the WiSE-CRT System was performed using a cohort-based economic model adopting a "proportion in state" structure. In addition to the primary analysis, scenario analyses and sensitivity analyses were performed to test for uncertainty in input parameters. Outcomes were quantified in terms of quality-adjusted life year (QALY) differences.
RESULTS
RESULTS
The primary analysis demonstrated that treatment with the WiSE-CRT system is likely to be cost-effective over a lifetime horizon at a QALY reimbursement threshold of £20 000, with a net monetary benefit (NMB) of £3781 per QALY. Cost-effectiveness declines at time horizons shorter than 10 years. Sensitivity analyses demonstrated that average system battery life had the largest impact on potential cost-effectiveness.
CONCLUSION
CONCLUSIONS
Within the model limitations, these findings support the use of WiSE-CRT in indicated patients from an economic standpoint. However, improving battery technology should be prioritized to maximize cost-effectiveness in times when health services are under significant financial pressures.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2590-2598Subventions
Organisme : British Heart Foundation
ID : FS/CRTF/22/24362
Pays : United Kingdom
Organisme : British Heart Foundation
ID : PG/15/91/31812
Pays : United Kingdom
Organisme : British Heart Foundation
ID : PG/13/37/30280
Pays : United Kingdom
Organisme : British Heart Foundation
ID : SP/18/6/33805
Pays : United Kingdom
Organisme : European Research Council
ID : ERC PREDICT-HF 864055
Pays : International
Informations de copyright
© 2023 The Authors. Journal of Cardiovascular Electrophysiology published by Wiley Periodicals LLC.
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