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Use of Two Intracorporeal Ventricular Assist Devices As a Total Artificial Heart
Published on: May 11, 2018
Cost comparison of heart transplant vs. left ventricular assist device therapy at one year
Silvana F Marasco1,2, Robyn Summerhayes1, Margaret Quayle1
1Department of Cardiothoracic Surgery, The Alfred Hospital, Prahran, Melbourne, Vic., Australia.
Insights
Ventricular assist device (VAD) therapy is costly, with higher initial expenses than heart transplantation (HTx). While HTx has greater subsequent costs, VADs require significant price reductions for broader, cost-effective use in heart failure treatment.
Area of Science:
- Cardiology
- Health Economics
- Medical Technology
Background:
- Growing demand for heart failure treatments due to donor organ shortages.
- Ventricular assist device (VAD) therapy is increasingly used as a bridge to transplant and destination therapy.
- Concerns exist regarding the high cost of VADs and associated care impacting healthcare expenditure.
Purpose of the Study:
- To compare the costs of the first 12 months of care for Ventricular Assist Device (VAD) therapy versus heart transplantation (HTx).
Main Methods:
- Single-center retrospective study analyzing real-world costs from 2010-2012.
- Included patients with 12 months of complete costing data.
- Analyzed costs for 28 HTx patients and 24 VAD patients.
Main Results:
- Index admission costs were over double for VAD patients compared to HTx patients, driven by procurement and length of stay.
- Subsequent costs were six times higher in the HTx group, primarily due to pharmaceutical expenses.
- VAD therapy represents a substantial financial commitment for end-stage heart failure management.
Conclusions:
- Ventricular assist device (VAD) therapy is an expensive treatment option for end-stage heart failure.
- Significant reductions in VAD device prices are necessary to enhance applicability and cost-effectiveness.
- Policy makers must consider VAD costs in relation to traditional heart transplantation expenditures.
Abstract:
With the worldwide shortage of donor organs, use of ventricular assist device (VAD) therapy is rapidly increasing in both the bridge to transplant and destination therapy settings. However, the high cost of VADs and VAD care is a cause for concern for policy makers who have relied on the limited supply of donor hearts to naturally cap health expenditure on heart transplantation (HTx). We sought to compare costs of the first 12 months of care of VADs vs. HTx. Single center retrospective study utilizing real generated costs over a three yr span from 2010-2012. Only patients with 12 months of costing data were included. Costs of 28 HTx patients and 24 VAD patients were analyzed. Index admission costs were more than double in the VAD group compared to the HTx group and this was driven by the procurement costs and length of stay which increased almost all aspects of in hospital care costs. Subsequent costs were six times higher in the HTx group and this was driven largely by pharmaceuticals. VAD therapy remains a very expensive treatment option for end stage heart failure patients. Device prices need to reduce substantially to make this a more widely applicable and cost effective treatment option.
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