TY - JOUR
T1 - Cost-effectiveness of the coronary sinus Reducer and its impact on the healthcare burden of refractory angina patients
AU - Gallone, Guglielmo
AU - Armeni, Patrizio
AU - Verheye, Stefan
AU - Agostoni, Pierfrancesco
AU - Timmers, Leo
AU - Campo, Gianluca
AU - Ielasi, Alfonso
AU - Sgura, Fabio
AU - Tarantini, Giuseppe
AU - Rosseel, Liesbeth
AU - Zivelonghi, Carlo
AU - Leenders, Geert
AU - Stella, Pieter
AU - Tebaldi, Matteo
AU - Tespili, Maurizio
AU - D'Amico, Gianpiero
AU - Baldetti, Luca
AU - Ponticelli, Francesco
AU - Colombo, Antonio
AU - Giannini, Francesco
N1 - Publisher Copyright:
All rights reserved. © The Author(s) 2019.
PY - 2020/1
Y1 - 2020/1
N2 - Aims The coronary sinus Reducer is a percutaneous device proven to improve angina symptoms in refractory angina (RA). We evaluated its potential cost-effectiveness and impact on the healthcare resource use. Methods Angina-related healthcare resource usage and quality-of-life data were collected for 215 consecutive RA patients and results undergoing Reducer implantation in Belgium, the Netherlands, and Italy. Costs were assessed from each country’s healthcare system perspective. Data from the date of RA diagnosis to Reducer implantation [Standard-of-Care (SoC)-period] and from Reducer implantation to follow-up (Reducer-period) were compared: during Reducer-period, a significant reduction in angina-driven hospitalizations, outpatient visits, coronary angiograms, and percutaneous coronary interventions per patient-year was observed, translating into significantly reduced costs per patient-year. To assess cost-effectiveness, costs and utilities of 1-year SoC were compared with those of 1-year Reducer-period. Assumptions on Reducer efficacy duration were further explored with modelled projections. Reducer was associated with higher quality-adjusted life years (QALYs: 0.665 vs. 0.580, P < 0.001) and incremental costs, yielding incremental cost-effectiveness ratios (ICERs) of 53 197, 34 948, 63 146 e/QALY gained in Belgium, the Netherlands, and Italy, respectively. Under both the assumptions of 2 and 3 years Reducer effect duration with a 30%-year efficacy decrease, the device yielded ICERs in the range of 1977–20 796 e/QALY gained. ................................................................................................................................................................................................... Conclusion In patients with RA, Reducer device decreases healthcare resource use and related costs. In a limited 1-year timeframe, Reducer is consistently cost-effective according to a range of cost-effectiveness thresholds. Under the explored assumptions, the device yields cost-effectiveness ratios suggesting high value from all the considered perspectives.
AB - Aims The coronary sinus Reducer is a percutaneous device proven to improve angina symptoms in refractory angina (RA). We evaluated its potential cost-effectiveness and impact on the healthcare resource use. Methods Angina-related healthcare resource usage and quality-of-life data were collected for 215 consecutive RA patients and results undergoing Reducer implantation in Belgium, the Netherlands, and Italy. Costs were assessed from each country’s healthcare system perspective. Data from the date of RA diagnosis to Reducer implantation [Standard-of-Care (SoC)-period] and from Reducer implantation to follow-up (Reducer-period) were compared: during Reducer-period, a significant reduction in angina-driven hospitalizations, outpatient visits, coronary angiograms, and percutaneous coronary interventions per patient-year was observed, translating into significantly reduced costs per patient-year. To assess cost-effectiveness, costs and utilities of 1-year SoC were compared with those of 1-year Reducer-period. Assumptions on Reducer efficacy duration were further explored with modelled projections. Reducer was associated with higher quality-adjusted life years (QALYs: 0.665 vs. 0.580, P < 0.001) and incremental costs, yielding incremental cost-effectiveness ratios (ICERs) of 53 197, 34 948, 63 146 e/QALY gained in Belgium, the Netherlands, and Italy, respectively. Under both the assumptions of 2 and 3 years Reducer effect duration with a 30%-year efficacy decrease, the device yielded ICERs in the range of 1977–20 796 e/QALY gained. ................................................................................................................................................................................................... Conclusion In patients with RA, Reducer device decreases healthcare resource use and related costs. In a limited 1-year timeframe, Reducer is consistently cost-effective according to a range of cost-effectiveness thresholds. Under the explored assumptions, the device yields cost-effectiveness ratios suggesting high value from all the considered perspectives.
KW - Chronic refractory angina
KW - Coronary sinus Reducer
KW - Cost-effectiveness
KW - Healthcare costs
KW - Quality of life
UR - http://www.scopus.com/inward/record.url?scp=85078576499&partnerID=8YFLogxK
U2 - 10.1093/ehjqcco/qcz027
DO - 10.1093/ehjqcco/qcz027
M3 - Article
C2 - 31124556
SN - 2058-1742
VL - 6
SP - 32
EP - 40
JO - European heart journal. Quality of care & clinical outcomes
JF - European heart journal. Quality of care & clinical outcomes
IS - 1
ER -