Cost-impact analysis of baroreflex activation therapy in chronic heart failure patients in the United States
| Autor: | Shawn Davies, John E. Schneider, Thomas F. Deering, Elizabeth Galle, Robert L. Ohsfeldt, John D. Bisognano, Ivana Stojanovic, JoAnn Lindenfeld, Michael R. Zile |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
lcsh:Diseases of the circulatory (Cardiovascular) system Baroreceptor Time Factors Cost-Benefit Analysis Electric Stimulation Therapy Pressoreceptors Economic Baroreflex activation therapy 030204 cardiovascular system & hematology Baroreflex 03 medical and health sciences 0302 clinical medicine Cost Savings Internal medicine medicine Humans 030212 general & internal medicine Angiology Heart Failure Ejection fraction business.industry Guideline Health Care Costs medicine.disease United States Cardiac surgery Costs Autonomic nervous system Models Economic Outcome and Process Assessment Health Care Treatment Outcome lcsh:RC666-701 Heart failure Chronic Disease Cardiology Cardiology and Cardiovascular Medicine business Research Article |
| Zdroj: | BMC Cardiovascular Disorders BMC Cardiovascular Disorders, Vol 21, Iss 1, Pp 1-9 (2021) |
| ISSN: | 1471-2261 |
| Popis: | Background The study evaluated the cost of baroreflex activation therapy plus guideline directed therapy (BAT + GDT) compared to GDT alone for HF patients with reduced ejection fraction and New York Heart Association Class III or II (with a recent history of III). Baroreflex activation therapy (BAT) is delivered by an implantable device that stimulates the baroreceptors through an electrode attached to the outside of the carotid artery, which rebalances the autonomic nervous system to regain cardiovascular (CV) homeostasis. The BeAT-HF trial evaluated the safety and effectiveness of BAT. Methods A cost impact model was developed from a U.S. health care payer or integrated delivery network perspective over a 3-year period for BAT + GDT versus GDT alone. Expected costs were calculated by utilizing 6-month data from the BeAT-HF trial and existing literature. HF hospitalization rates were extrapolated based on improvement in NT-proBNP. Results At baseline the expected cost of BAT + GDT were $29,526 per patient more than GDT alone due to BAT device and implantation costs. After 3 years, the predicted cost per patient was $9521 less expensive for BAT + GDT versus GDT alone due to lower rates of significant HF hospitalizations, CV non-HF hospitalizations, and resource intensive late-stage procedures (LVADs and heart transplants) among the BAT + GDT group. Conclusions BAT + GDT treatment becomes less costly than GDT alone beginning between years 1 and 2 and becomes less costly cumulatively between years 2 and 3, potentially providing significant savings over time. As additional BeAT-HF trial data become available, the model can be updated to show longer term effects. |
| Databáze: | OpenAIRE |
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