Cost-effectiveness of Ventricular Assist Device Use in the United Kingdom: Results From the Evaluation of Ventricular Assist Device Programme in the UK (EVAD-UK)
| Autor: | Martin Buxton, Nicholas R. Banner, Fay Cafferty, Nikolaos Demiris, N. Caine, Matthew Dyer, Carol Freeman, Steven Tsui, Stephen R. Large, Linda D. Sharples |
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| Rok vydání: | 2006 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Cost effectiveness Cost-Benefit Analysis medicine.medical_treatment Cohort Studies Quality of life Outcome Assessment Health Care medicine Humans Prospective Studies Intensive care medicine Transplantation Cost–benefit analysis business.industry Length of Stay Survival Analysis United Kingdom Quality-adjusted life year Ventricular assist device Cohort Quality of Life Heart Transplantation Surgery Heart-Assist Devices Quality-Adjusted Life Years Cardiology and Cardiovascular Medicine business Cohort study |
| Zdroj: | The Journal of Heart and Lung Transplantation. 25:1336-1343 |
| ISSN: | 1053-2498 |
| DOI: | 10.1016/j.healun.2006.09.011 |
| Popis: | The UK Department of Health funds ventricular assist device (VAD) implantation as a bridge to transplantation (BTT) at three centers. The cost-effectiveness of this program has not been established.All 70 VAD implants for BTT and a consecutive cohort of 71 inotrope-dependent transplant candidates, between April 2002 and December 2004, were prospectively monitored for survival, transplantation, quality of life and resource use. Costs and quality-adjusted life-years were estimated for these groups, and for a hypothetical scenario in which VAD patients would die within 30 days in the absence of the program.Mean quality-adjusted life-years for a VAD patient was 3.27 at a lifetime cost of 173,841 pounds (316,078 US dollars). The majority of the cost was attributable to the VAD implant (63,830 pounds, 116,056 US dollars) and the initial hospital stay in the ITU and ward (14,500 pounds, 26,364 US dollars). Inotrope-dependent transplant candidates had mean quality-adjusted life-years of 4.99 at a lifetime cost of 130,905 pounds (238,011 US dollars). The worst clinical scenario resulted in a lifetime cost of 14,400 pounds (26,182 US dollars), based on 1 month in the ICU (mean 15 days). These figures were robust to a range of plausible assumptions.A lifetime model based on current UK practice demonstrates that BTT VAD patients had significant quality-adjusted life-years, but treatment was expensive when compared with the worst clinical scenario. If device technology improves, costs are reduced, or referral practice changes, results should be re-assessed. |
| Databáze: | OpenAIRE |
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