Preliminary report on the cost effectiveness of ventricular assist devices

Takura, Tomoyuki; Kyo, Shunei; Ōno, Minoru; Tominaga, Ryuji; Miyagawa, Shigeru; Tanoue, Yoshihisa; Sawa, Yoshiki

doi:10.1007/s10047-015-0858-5

Cited by 13 publications

(19 citation statements)

References 20 publications

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“…a dialysis machine) is introduced in caring for the sickest patients or the most severe of cases, health care costs escalate. In some conditions, where patient costs dramatically escalate, investment in technology and expenditures on invasive procedures for the “sickest of the sick”, it could be argued, does pay off [24]. An example of this is the use of Biventricular heart assist devices (BiVad) in the congestive heart failure population.…”

Section: Discussionmentioning

confidence: 99%

Assessing key cost drivers associated with caring for chronic kidney disease patients

Damien

Lanham

Parthasarathy³

et al. 2016

BMC Health Serv Res

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BackgroundTo examine key factors influencing chronic kidney disease (CKD) patients’ total expenditure and offer recommendations on how to reduce total cost of CKD care without compromising quality.MethodsUsing the 2002–2011 Medical Expenditure Panel Survey (MEPS) data, our cross-sectional study analyzed 197 patient records—79 patients with one record and 59 with two entries per patient (138 unique patients). We used three patient groups, based on international statistical classification of diseases version 9 code for condition (ICD9CODX) classification, to focus inference from the analysis: (a) non-dialysis dependent CKD, (b) dialysis and (c) transplant. Covariate information included region, demographic, co-morbid conditions and types of services. We used descriptive methods and multivariate generalized linear models to understand the impact of cost drivers. We compared actual and predicted CKD cost of care data using a hold-out sample of nine, randomly selected patients to validate the models.ResultsTotal costs were significantly affected by treatment type, with dialysis being significantly higher than non-dialysis and transplant groups. Costs were highest in the West region of the U.S. Average costs for patients with public insurance were significantly higher than patients with private insurance (p < .0743), and likewise, for patients with co-morbid conditions over those without co-morbid conditions (p < .001).ConclusionsManaging CKD patients both before and after the onset of dialysis treatment and managing co-morbid conditions in individuals with CKD are potential sources of substantial cost savings in the care of CKD patients. Comparing total costs pre and post the United States Affordable Care Act could provide invaluable insights into managing the cost-quality tradeoff in CKD care.

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Section: Discussionmentioning

confidence: 99%

Assessing key cost drivers associated with caring for chronic kidney disease patients

Damien

Lanham

Parthasarathy³

et al. 2016

BMC Health Serv Res

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“…8,9 VAD has been constituted as an alternative for HF treatment, both as destination therapy 10 and as a bridge to HT in more than 50% of the HT performed worldwide. Multiple studies have compared the cost of implanting a VAD with the cost of a HT [11][12][13][14][15][16] and found a low cost-effectiveness ratio, especially in Spain where the cost of HTs is lower than in other countries. Multiple studies have compared the cost of implanting a VAD with the cost of a HT [11][12][13][14][15][16] and found a low cost-effectiveness ratio, especially in Spain where the cost of HTs is lower than in other countries.…”

mentioning

confidence: 99%

“…5 VAD implantation is economically limited in some countries due to their high acquisition costs. Multiple studies have compared the cost of implanting a VAD with the cost of a HT [11][12][13][14][15][16] and found a low cost-effectiveness ratio, especially in Spain where the cost of HTs is lower than in other countries. 17 Despite these data, there is a constant increase in the number of implanted LVADs in developed countries, especially in those with better economical situation and lower donation rates, where emergent HT is significantly limited.…”

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confidence: 99%

Elective or emergency heart transplantation: Cost comparison in a single center

Farrero

Flores‐Umanzor

Pomar

et al. 2019

Clinical Transplantation

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Background and aims Heart transplantation (HT) is the treatment of choice for selected cases of advanced heart failure. There is an increasing rate of emergency HT in our country. The aim of this study was to determine the cost of HT in our hospital according to emergent vs. elective transplantation status. Methods The costs of all consecutive HTs performed in our center between January 2010 and May 2015 were analyzed. The cost of elective and emergent HT was compared. Results HT mean cost at our institution was €62 203 ± 47 976. Elective HT mean cost was €47 540 ± 25 140, whereas emergent HT cost was €102 733 ± 68 050 (emergency status 1, as regional priority, was €66 077 ± 28 067 and emergency status 0, as the highest national priority, was €136 056 ± 77 080; P < 0.001). Increased emergent HT cost was mainly related to a longer admission (32 ± 24 days vs. 69 ± 53 days; P = 0.006; accounting for a cost of €14 517 ± 12 475 vs. €37 846 ± 31 702; P < 0.001) and increased drug‐related expenses (€6622 ± 7465 vs. €15,171 ± 15,758; P < 0.02). Elective HT survival rate was 96%, compared to 68% for emergent HT; P = 0.002. Conclusions Elective HT showed a high survival rate with a relatively low and less variable cost, leading to a favorable economic balance in today's public health reimbursement system. In contrast, emergent HT showed a higher cost and a lower survival rate. New treatment strategies should be identified for heart failure patients at risk of requiring emergency HT.

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“…Authors considered a lifetime horizon in eleven publications (84.6 percent). Other horizons adopted were 5 years (20) in one study and 12 months (21) in another study. Five articles (38.5 percent) did not specify a funding source.…”

Section: Resultsmentioning

confidence: 99%

“…In most studies (84.6 percent), cost data were of high quality (level A). Among them, one study (21) estimated costs based on a reliable database from a specific study. For two publications (15.4 percent), cost data were of poor quality; one used price rather than cost (16) and the other was based on costs from a different jurisdiction (20).…”

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confidence: 99%

Quality of economic evaluations of ventricular assist devices: A systematic review

Fontenay

Catarino

Snoussi

et al. 2020

Int J Technol Assess Health Care

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Objective Because of a lack of suitable heart donors, alternatives to transplantation are required. These alternatives can have high costs. The aim of this study was to perform a systematic review of cost-effectiveness studies of ventricular assist devices (VADs) and to assess the level of evidence of relevant studies. The purpose was not to present economic findings. Methods A systematic review was performed using four electronic databases to identify health economic evaluation studies dealing with VADs. The methodological quality and reporting quality of the studies was assessed using three different tools, the Drummond, Cooper, and CHEERS (Consolidated Health Economic Evaluation Reporting Standards) checklists. Results Of the 1,258 publications identified, thirteen articles were included in this review. Twelve studies were cost–utility analyses and one was a cost-effectiveness analysis. According to the Cooper hierarchy scale, the quality of the data used was heterogeneous. The level of evidence used for clinical effect sizes, safety data, and baseline clinical data was of poor quality. In contrast, cost data were of high quality in most studies. Quality of reporting varied between studies, with an average score of 17.4 (range 15–19) according to the CHEERS checklist. Conclusion The current study shows that the quality of clinical data used in economic evaluations of VADs is rather poor in general. This is a concern that deserves greater attention in the process of health technology assessment of medical devices.

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Preliminary report on the cost effectiveness of ventricular assist devices

Cited by 13 publications

References 20 publications

Assessing key cost drivers associated with caring for chronic kidney disease patients

Assessing key cost drivers associated with caring for chronic kidney disease patients

Elective or emergency heart transplantation: Cost comparison in a single center

Quality of economic evaluations of ventricular assist devices: A systematic review

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