Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina.
<h4>Background</h4>Centrifugal-flow pumps are novel treatment options for patients with advanced heart failure (HF). This study estimated the incremental cost-effectiveness ratio (ICER) of centrifugal-flow pumps for patients with advanced HF in Argentina.<h4>Methods</h4>Two M...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0271519 |
| _version_ | 1798036018353405952 |
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| author | Andrea Alcaraz Andres Pichon-Riviere Carlos Rojas-Roque Juan Martín González Daniela Prina Germán Solioz Federico Augustovski Alfredo Palacios |
| author_facet | Andrea Alcaraz Andres Pichon-Riviere Carlos Rojas-Roque Juan Martín González Daniela Prina Germán Solioz Federico Augustovski Alfredo Palacios |
| author_sort | Andrea Alcaraz |
| collection | DOAJ |
| description | <h4>Background</h4>Centrifugal-flow pumps are novel treatment options for patients with advanced heart failure (HF). This study estimated the incremental cost-effectiveness ratio (ICER) of centrifugal-flow pumps for patients with advanced HF in Argentina.<h4>Methods</h4>Two Markov models were developed to estimate the cost-effectiveness of a centrifugal-flow pump as destination therapy (DT) in patients with contraindication for heart transplantation, and as bridge-to-transplant (BTT), with a lifetime horizon using the third-party payer Social Security (SS) and Private Sector (PS) perspectives. Clinical, epidemiological, and quality-adjusted life years (QALY) parameters were retrieved from the literature. Direct medical costs were estimated through a micro-costing approach (exchange rate USD 1 = ARS 59.95).<h4>Results</h4>The centrifugal-flow pump as a DT increased the per patient QALYs by 3.5 and costs by ARS 8.1 million in both the SS and PS, with an ICER of ARS 2.3 million per QALY. Corresponding values for a centrifugal-flow pump as BTT were 0.74 QALYs and more than ARS 8 million, yielding ICERs of ARS 11 million per QALY (highly dependent on waiting times). For the 1, 3, and 5 GDP per QALY thresholds, the probability of a centrifugal-flow pump to be cost-effective for DT/BTT was around 2%/0%, 40%/0%, and 80%/1%, respectively.<h4>Conclusion</h4>The centrifugal-flow pump prolongs life and improves the quality of life at significantly higher costs. As in Argentina there is no current explicit cost-effectiveness threshold, the final decision on reimbursement will depend on the willingness to pay in each subsector. Nevertheless, the centrifugal-flow pump as a DT was more cost-effective than as a BTT. |
| first_indexed | 2024-04-11T21:06:34Z |
| format | Article |
| id | doaj.art-0fd7d7a24d524603b23fe9527d766f1e |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-11T21:06:34Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-0fd7d7a24d524603b23fe9527d766f1e2022-12-22T04:03:16ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01178e027151910.1371/journal.pone.0271519Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina.Andrea AlcarazAndres Pichon-RiviereCarlos Rojas-RoqueJuan Martín GonzálezDaniela PrinaGermán SoliozFederico AugustovskiAlfredo Palacios<h4>Background</h4>Centrifugal-flow pumps are novel treatment options for patients with advanced heart failure (HF). This study estimated the incremental cost-effectiveness ratio (ICER) of centrifugal-flow pumps for patients with advanced HF in Argentina.<h4>Methods</h4>Two Markov models were developed to estimate the cost-effectiveness of a centrifugal-flow pump as destination therapy (DT) in patients with contraindication for heart transplantation, and as bridge-to-transplant (BTT), with a lifetime horizon using the third-party payer Social Security (SS) and Private Sector (PS) perspectives. Clinical, epidemiological, and quality-adjusted life years (QALY) parameters were retrieved from the literature. Direct medical costs were estimated through a micro-costing approach (exchange rate USD 1 = ARS 59.95).<h4>Results</h4>The centrifugal-flow pump as a DT increased the per patient QALYs by 3.5 and costs by ARS 8.1 million in both the SS and PS, with an ICER of ARS 2.3 million per QALY. Corresponding values for a centrifugal-flow pump as BTT were 0.74 QALYs and more than ARS 8 million, yielding ICERs of ARS 11 million per QALY (highly dependent on waiting times). For the 1, 3, and 5 GDP per QALY thresholds, the probability of a centrifugal-flow pump to be cost-effective for DT/BTT was around 2%/0%, 40%/0%, and 80%/1%, respectively.<h4>Conclusion</h4>The centrifugal-flow pump prolongs life and improves the quality of life at significantly higher costs. As in Argentina there is no current explicit cost-effectiveness threshold, the final decision on reimbursement will depend on the willingness to pay in each subsector. Nevertheless, the centrifugal-flow pump as a DT was more cost-effective than as a BTT.https://doi.org/10.1371/journal.pone.0271519 |
| spellingShingle | Andrea Alcaraz Andres Pichon-Riviere Carlos Rojas-Roque Juan Martín González Daniela Prina Germán Solioz Federico Augustovski Alfredo Palacios Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina. PLoS ONE |
| title | Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina. |
| title_full | Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina. |
| title_fullStr | Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina. |
| title_full_unstemmed | Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina. |
| title_short | Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina. |
| title_sort | cost effectiveness of a centrifugal flow pump for patients with advanced heart failure in argentina |
| url | https://doi.org/10.1371/journal.pone.0271519 |
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