Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina
Background 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. Methods Two Markov models were developed to estimate...
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| Veröffentlicht in: | PloS one 2022-08, Vol.17 (8), p.e0271519-e0271519 |
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| creator | Alcaraz, Andrea Pichon-Riviere, Andres Rojas-Roque, Carlos González, Juan Martín Prina, Daniela Solioz, Germán Augustovski, Federico Palacios, Alfredo |
| description | Background 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. Methods 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). Results 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. Conclusion 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. |
| doi_str_mv | 10.1371/journal.pone.0271519 |
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This study estimated the incremental cost-effectiveness ratio (ICER) of centrifugal-flow pumps for patients with advanced HF in Argentina. Methods 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). Results 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. Conclusion 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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0271519</identifier><identifier>PMID: 35913940</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Biology and Life Sciences ; Care and treatment ; Centrifugal pumps ; Congestive heart failure ; Contraindications ; Cost analysis ; Cost benefit analysis ; Costs ; Decision making ; Epidemiology ; Evaluation ; Flow ; GDP ; Gross Domestic Product ; Health risks ; Heart failure ; Heart transplantation ; Heart transplants ; Intervention ; Markov chains ; Medical care, Cost of ; Medical prognosis ; Medical treatment ; Medicine and Health Sciences ; Mortality ; Patient outcomes ; Patients ; People and places ; Population ; Private sector ; Pumps ; Quality of life ; Social Sciences ; Social security ; Transplantation ; Willingness to pay</subject><ispartof>PloS one, 2022-08, Vol.17 (8), p.e0271519-e0271519</ispartof><rights>COPYRIGHT 2022 Public Library of Science</rights><rights>2022 Alcaraz et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 Alcaraz et al 2022 Alcaraz et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c548t-3b3d73faa4911373d9bba33328444ee2b4e004cd30a7bf59e0f63b7dcd1782b33</cites><orcidid>0000-0002-1474-1550 ; 0000-0001-7684-0880 ; 0000-0003-2854-1557</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9342761/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9342761/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids></links><search><contributor>Zúniga-González, Carlos Alberto</contributor><creatorcontrib>Alcaraz, Andrea</creatorcontrib><creatorcontrib>Pichon-Riviere, Andres</creatorcontrib><creatorcontrib>Rojas-Roque, Carlos</creatorcontrib><creatorcontrib>González, Juan Martín</creatorcontrib><creatorcontrib>Prina, Daniela</creatorcontrib><creatorcontrib>Solioz, Germán</creatorcontrib><creatorcontrib>Augustovski, Federico</creatorcontrib><creatorcontrib>Palacios, Alfredo</creatorcontrib><title>Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina</title><title>PloS one</title><description>Background 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. Methods 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). Results 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. Conclusion 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.</description><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Centrifugal pumps</subject><subject>Congestive heart failure</subject><subject>Contraindications</subject><subject>Cost analysis</subject><subject>Cost benefit analysis</subject><subject>Costs</subject><subject>Decision making</subject><subject>Epidemiology</subject><subject>Evaluation</subject><subject>Flow</subject><subject>GDP</subject><subject>Gross Domestic Product</subject><subject>Health risks</subject><subject>Heart failure</subject><subject>Heart transplantation</subject><subject>Heart transplants</subject><subject>Intervention</subject><subject>Markov chains</subject><subject>Medical care, Cost of</subject><subject>Medical prognosis</subject><subject>Medical treatment</subject><subject>Medicine and Health Sciences</subject><subject>Mortality</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>People and places</subject><subject>Population</subject><subject>Private sector</subject><subject>Pumps</subject><subject>Quality of life</subject><subject>Social Sciences</subject><subject>Social security</subject><subject>Transplantation</subject><subject>Willingness to 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of a centrifugal-flow pump for patients with advanced heart failure in Argentina</title><author>Alcaraz, Andrea ; Pichon-Riviere, Andres ; Rojas-Roque, Carlos ; González, Juan Martín ; Prina, Daniela ; Solioz, Germán ; Augustovski, Federico ; Palacios, Alfredo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c548t-3b3d73faa4911373d9bba33328444ee2b4e004cd30a7bf59e0f63b7dcd1782b33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Biology and Life Sciences</topic><topic>Care and treatment</topic><topic>Centrifugal pumps</topic><topic>Congestive heart failure</topic><topic>Contraindications</topic><topic>Cost analysis</topic><topic>Cost benefit analysis</topic><topic>Costs</topic><topic>Decision making</topic><topic>Epidemiology</topic><topic>Evaluation</topic><topic>Flow</topic><topic>GDP</topic><topic>Gross Domestic Product</topic><topic>Health risks</topic><topic>Heart failure</topic><topic>Heart transplantation</topic><topic>Heart transplants</topic><topic>Intervention</topic><topic>Markov chains</topic><topic>Medical care, Cost of</topic><topic>Medical prognosis</topic><topic>Medical treatment</topic><topic>Medicine and Health Sciences</topic><topic>Mortality</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>People and places</topic><topic>Population</topic><topic>Private sector</topic><topic>Pumps</topic><topic>Quality of life</topic><topic>Social Sciences</topic><topic>Social security</topic><topic>Transplantation</topic><topic>Willingness to pay</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Alcaraz, Andrea</creatorcontrib><creatorcontrib>Pichon-Riviere, Andres</creatorcontrib><creatorcontrib>Rojas-Roque, Carlos</creatorcontrib><creatorcontrib>González, Juan Martín</creatorcontrib><creatorcontrib>Prina, Daniela</creatorcontrib><creatorcontrib>Solioz, 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Alberto</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina</atitle><jtitle>PloS one</jtitle><date>2022-08-01</date><risdate>2022</risdate><volume>17</volume><issue>8</issue><spage>e0271519</spage><epage>e0271519</epage><pages>e0271519-e0271519</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Background 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. Methods 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). Results 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. Conclusion 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.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>35913940</pmid><doi>10.1371/journal.pone.0271519</doi><tpages>e0271519</tpages><orcidid>https://orcid.org/0000-0002-1474-1550</orcidid><orcidid>https://orcid.org/0000-0001-7684-0880</orcidid><orcidid>https://orcid.org/0000-0003-2854-1557</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Biology and Life Sciences Care and treatment Centrifugal pumps Congestive heart failure Contraindications Cost analysis Cost benefit analysis Costs Decision making Epidemiology Evaluation Flow GDP Gross Domestic Product Health risks Heart failure Heart transplantation Heart transplants Intervention Markov chains Medical care, Cost of Medical prognosis Medical treatment Medicine and Health Sciences Mortality Patient outcomes Patients People and places Population Private sector Pumps Quality of life Social Sciences Social security Transplantation Willingness to pay |
| title | Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-27T21%3A39%3A07IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Cost-effectiveness%20of%20a%20centrifugal-flow%20pump%20for%20patients%20with%20advanced%20heart%20failure%20in%20Argentina&rft.jtitle=PloS%20one&rft.au=Alcaraz,%20Andrea&rft.date=2022-08-01&rft.volume=17&rft.issue=8&rft.spage=e0271519&rft.epage=e0271519&rft.pages=e0271519-e0271519&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0271519&rft_dat=%3Cgale_plos_%3EA712207277%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2697076545&rft_id=info:pmid/35913940&rft_galeid=A712207277&rft_doaj_id=oai_doaj_org_article_0fd7d7a24d524603b23fe9527d766f1e&rfr_iscdi=true |