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Published on: December 11, 2017
Cost effectiveness of cardiac resynchronization therapy in Greece: an analysis based on the CArdiac REsychronization
N Maniadakis1, M Ekman, M J Calvert
1Department of Health Services Management, National School of Public Health, Athens, Greece. nmaniadakis@esdy.edu.gr
Insights
Cardiac resynchronization therapy (CRT) is a cost-effective treatment for moderate-to-severe heart failure in Greece. Adding CRT to medical therapy improves quality-adjusted life years gained, making it a recommended option.
Area of Science:
- Health economics
- Cardiology
- Public health
Background:
- Healthcare systems increasingly prioritize economic evaluations.
- Heart failure management involves significant resource allocation.
- Cardiac resynchronization therapy (CRT) is an emerging treatment option.
Purpose of the Study:
- To evaluate the incremental cost-effectiveness of CRT plus medical therapy versus medical therapy alone in Greece.
- To assess the economic value of CRT within the Greek healthcare system.
Main Methods:
- Health economic analysis based on the CARE-HF randomized clinical trial.
- Combined healthcare resource utilization data with CRT implantation and hospitalization costs.
- Utilized a lifetime perspective with sensitivity analyses for shorter time horizons.
Main Results:
- The cost per quality-adjusted life year (QALY) gained with CRT was €6,045 in Greece.
- The 95% confidence interval for the cost-effectiveness ratio was €4,292-€9,411 per QALY gained.
- CRT demonstrated a favorable economic return in the studied population.
Conclusions:
- Cardiac resynchronization therapy is a cost-effective treatment for moderate-to-severe heart failure patients with dyssynchrony markers in Greece.
- CRT can be recommended for routine clinical use in this patient group.
- Economic evaluations support the integration of CRT into standard heart failure care.
Aims:
Health economic considerations have become increasingly important in healthcare. The aim of this study was to investigate the incremental cost effectiveness of cardiac resynchronization therapy (CRT) plus medical therapy compared with medical therapy alone in the Greek health-care system.
Methods And Results:
The health economic analysis was based on the CARE-HF trial, a randomized clinical trial estimating the efficacy of adding CRT (n = 409) to optimal pharmacological treatment (n = 404) in patients with moderate-to-severe heart failure with markers of cardiac dyssynchrony. Health care resource use from CArdiac REsychronization in Heart Failure was combined with costs for CRT implantation and hospitalization from publicly available sources. The analysis was based on a lifetime perspective, with the life expectancy estimated from the clinical trial data. Shorter time horizons were explored in the sensitivity analysis. The cost per quality-adjusted life year (QALY) gained with CRT was €6,045 in Greece, with a 95% confidence interval for the cost-effectiveness ratio of €4,292-9,411 per QALY gained.
Conclusions:
The results of the economic evaluation of CRT in Greek health-care setting indicate that it is a cost-effective treatment compared with traditional pharmacological therapy. Cardiac resynchronization therapy can therefore be recommended for routine use in patients with moderate-to-severe heart failure and markers of dyssynchrony.
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