A cost-effectiveness analysis comparing a conventional mechanical needle to a radiofrequency device for transseptal punctures
| Autor: | Rahil Shah, Leslie Wilson, Gregory M. Marcus, Yao Kouassi, José M. Sanchez, Matthew Chronowic |
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| Rok vydání: | 2020 |
| Předmět: |
Cost effectiveness
business.industry medicine.medical_treatment Cost-Benefit Analysis Catheter ablation Cost-effectiveness analysis Punctures 030204 cardiovascular system & hematology 03 medical and health sciences Catheter 0302 clinical medicine Treatment Outcome Needles Physiology (medical) Cardiac procedures Atrial Fibrillation medicine Catheter Ablation Humans 030212 general & internal medicine Cardiology and Cardiovascular Medicine business Sensitivity analyses health care economics and organizations Biomedical engineering |
| Zdroj: | Journal of cardiovascular electrophysiologyREFERENCES. 31(7) |
| ISSN: | 1540-8167 |
| Popis: | Introduction Transseptal puncture is an integral step in various catheter-based cardiac procedures and can be performed with either the conventional mechanical needle or an FDA-cleared device utilizing radiofrequency (RF) energy. Although a previous randomized trial suggested that the RF transseptal device may be faster and more often successful, the increased equipment costs may dissuade operators from routine use. This analysis compares the cost-effectiveness of the mechanical needle to the RF device during pulmonary vein isolation. Methods The rates of successful transseptal punctures for each device and transseptal-related complications were determined from the peer-reviewed medical literature. Procedural, equipment, and complication costs were obtained from peer-reviewed medical literature and the Healthcare Cost and Utilization Project. The effectiveness was defined as the probability of 30-day survival following a successful transseptal puncture. Monte Carlo probabilistic analyses tested variable effects of costs and complication rates on the incremental cost-effectiveness ratio. Results The 30-day effectiveness of the RF device vs the mechanical needle was 99.7% and 98.8%, respectively. After accounting for all costs of performing a single transseptal puncture, the cost at 30 days associated with the RF device was $41 less than the mechanical needle ($21 096 vs $21 137). The RF device was similarly dominant to the mechanical needle in double transseptal puncture scenarios. Finally, the RF device was more cost-effective than the mechanical needle at any willingness-to-pay in Monte Carlo probabilistic sensitivity analyses. Conclusions Despite greater equipment costs, the RF device costs less and provides better effectiveness at 30 days than the conventional mechanical needle. |
| Databáze: | OpenAIRE |
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