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Published on: August 9, 2024
Economic Analysis of the CADScor System for Ruling Out Coronary Artery Disease in England
Mehdi Javanbakht1,2, Atefeh Mashayekhi3, Mohsen Rezaei Hemami4
1Optimax Access UK Ltd, Market Access Consultancy, University of Southampton Science Park, Chilworth Hampshire, Kenneth Dibben House, Enterprise Rd, Chilworth, Southampton Science Park, Southampton, SO16 7NS, UK. Mehdi.Javanbakht@Optimaxaccess.com.
Insights
The CADScor System offers a cost-saving approach for diagnosing coronary artery disease (CAD), potentially saving the healthcare system millions. This early acoustic detection method improves patient outcomes and reduces overall healthcare expenditure.
Area of Science:
- Cardiovascular Medicine
- Health Economics
- Medical Device Technology
Background:
- Coronary artery disease (CAD) is a leading global cause of mortality, with current diagnostic pathways being costly and potentially leading to patient complications.
- The CADScor System, a novel acoustic detection device, aims to diagnose CAD earlier, circumventing invasive procedures.
Purpose of the Study:
- To evaluate the cost-utility of the CADScor System for early-stage diagnosis of CAD within England's healthcare system.
- Assessing the economic impact and diagnostic efficiency of integrating the CADScor System into the existing diagnostic pathway.
Main Methods:
- A two-part economic model, incorporating a decision tree and a Markov model, was utilized to assess cost per quality-adjusted life-year (QALY).
- The model analyzed short-term diagnostic outcomes and long-term health/economic implications, considering various time horizons.
- Deterministic and probabilistic sensitivity analyses were performed to explore parameter uncertainty.
Main Results:
- The CADScor System demonstrated cost savings of approximately £131 per patient with a marginal increase in QALYs over a 1-year horizon.
- Probabilistic analyses showed a >99% likelihood of cost-effectiveness at a £20,000/QALY threshold and 100% probability of being cost-saving.
- Sensitivity analyses identified CADScor System accuracy, cost, and CAD prevalence as key influencing factors. Estimated overall savings exceed £12.3 million per 100,000 patients.
Conclusions:
- The CADScor System presents a potentially cost-saving diagnostic tool for coronary artery disease.
- Implementing this system before non-invasive imaging tests like computed tomography coronary angiography can reduce healthcare service costs across different timeframes.
Background:
Coronary artery disease (CAD) is the most common type of heart and circulatory disease and is the leading cause of death worldwide. The current diagnostic pathway can lead to patient complications and is also extremely costly. A new medical device, the CADScor System (Acarix AB), was developed for the acoustic detection of CAD before patients undergo invasive diagnostic procedures.
Objectives:
Our objective was to assess the cost utility of the CADScor System for the diagnosis of CAD at an early stage in the diagnostic testing pathway in England.
Methods:
A two-part economic model, consisting of a decision tree and Markov model, was developed to consider the cost utility (cost per quality-adjusted life-year [QALY] gained) of introducing the CADScor System for the diagnosis of CAD. The decision tree component explored the short-term costs and diagnostic outcomes associated with introduction of the test compared with the existing testing pathway. A Markov model was developed to explore the longer-term health and economic implications of the condition and original diagnosis, with costs and health effects estimated over different time horizons. Parameter uncertainty was explored in deterministic and probabilistic sensitivity analyses.
Results:
Base-case results indicated that the CADScor System would result in cost savings (- £131 per patient) and a marginal increase in QALYs (0.00001) over a 1-year time horizon. Probabilistic results indicated that the intervention had a > 99% probability of being cost effective at a willingness-to-pay threshold of £20,000 per QALY gained and 100% probability of being cost saving. Results from the deterministic sensitivity analyses indicated that variations in parameters related to the accuracy and cost of the CADScor System, and the prevalence of CAD, had the greatest impact on the overall results. The overall cost saving was estimated to be over £12.3 million per 100,000 eligible patient population.
Conclusions:
The CADScor System is a potentially cost-saving test for the diagnosis of CAD. When initiated before the use of non-invasive cardiac imaging tests such as computed tomography coronary angiography, the test reduced costs to the healthcare service over various time horizons.
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