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Early decision-analytic modeling - a case study on vascular closure devices.

Alina Brandes1, Moritz F Sinner2, Stefan Kääb3,4

  • 1Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Ingolstädter Landstrasse 1, 85764, Neuherberg, Germany. post@alinabrandes.de.

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Summary

Value-based pricing for a new vascular closure device showed limited cost savings. Modifying care pathways, like same-day discharge, offers greater value for payers and providers.

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Area of Science:

  • Health Economics
  • Medical Device Innovation
  • Cost-Effectiveness Analysis

Background:

  • Healthcare reimbursement increasingly emphasizes economic considerations.
  • Early economic evaluations are crucial for medical innovation decisions, including cost-effectiveness.
  • Value-based pricing is a potential concept for early assessment of medical innovations.

Purpose of the Study:

  • To assess the feasibility of value-based pricing and product design for a hypothetical pre-clinical vascular closure device.
  • To estimate the cost-effectiveness of vascular closure devices from a Statutory Health Insurance perspective.
  • To explore strategies for determining product value, including avoided complications and care pathway modifications.

Main Methods:

  • Developed a deterministic decision-analytic model.
  • Estimated cost-effectiveness of established vascular closure devices.
  • Explored three value determination strategies: savings from avoided complications, willingness-to-pay thresholds, and care pathway modifications.

Main Results:

  • The hypothetical device reduced complication rates but at a higher cost than manual compression, yielding minimal savings (€4 per catheterization).
  • Efficiency frontier extrapolation was limited to specific subgroups.
  • Same-day discharge strategies could yield significant cost savings (€400-600 per catheterization).

Conclusions:

  • Value-based pricing was partially feasible for informing product design.
  • Modifying care pathways, particularly enabling same-day discharge, offers greater value than device modification alone.
  • Manufacturers should consider integrating product reimbursement with care pathway changes to enhance hospital attractiveness.