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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Cost-Effectiveness of Cardiac Resynchronization Therapy in Patients with Heart Failure in Thailand

Unchalee Permsuwan1, Arintaya Phrommintikul2, Voratima Silavanich1

  • 1Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand.

Clinicoeconomics and Outcomes Research : CEOR
|October 29, 2020
PubMed

Insights

Cardiac resynchronization therapy (CRT) is a cost-effective treatment for heart failure (HF) patients in Thailand. Despite higher initial costs, CRT significantly improves quality-adjusted life-years (QALYs) within the national willingness-to-pay threshold.

Area of Science:

  • Health economics
  • Cardiology
  • Medical technology assessment

Background:

  • Cardiac resynchronization therapy (CRT) enhances outcomes in heart failure (HF) patients.
  • High costs of CRT pose challenges for middle-income countries like Thailand.
  • Evaluating CRT's cost-effectiveness is crucial for resource allocation in Thai healthcare.

Purpose of the Study:

  • To analyze the cost-effectiveness of CRT combined with optimal medical therapy (OMT) versus OMT alone in Thai HF patients.
  • To determine if CRT is a worthwhile investment within Thailand's healthcare budget constraints.

Main Methods:

  • A two-component model assessed lifetime costs and quality-adjusted life-years (QALYs) from a healthcare perspective.
  • Clinical data derived from meta-analyses of landmark trials; Thai-specific data used for costs and non-cardiovascular risks.
  • Incremental Cost-Effectiveness Ratio (ICER) calculated, with sensitivity analyses performed.

Main Results:

  • CRT plus OMT incurred higher costs (123,279 THB) but yielded more QALYs (3.57) compared to OMT alone (11,165 THB, 2.49 QALYs).
  • The ICER was 104,325 THB per QALY, which is below Thailand's willingness-to-pay threshold of 160,000 THB per QALY.
  • Sensitivity analyses indicated that CRT maintenance costs significantly influence the results.

Conclusions:

  • Cardiac resynchronization therapy is a cost-effective intervention for heart failure patients in Thailand.
  • The clinical benefits of CRT are achievable at a reasonable cost, supporting its adoption in the Thai healthcare system.
  • Cost-effectiveness supports the use of CRT within established economic benchmarks for therapeutic interventions.
Abstract

Keywords:
Thailandcardiac resynchronization therapycost-effectivenessheart failurequality-adjusted life-years

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