Cost-effectiveness analysis of leadless cardiac resynchronization therapy
Nadeev Wijesuriya1,2, Vishal Mehta1,2, Felicity De Vere1,2
1School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
Journal of Cardiovascular Electrophysiology
|October 10, 2023
Summary
The Wireless Stimulation Endocardially for CRT (WiSE-CRT) system is a cost-effective treatment for heart failure. Improving battery life enhances its economic value, supporting its use in clinical practice.
Area of Science:
- Cardiology
- Health Economics
- Medical Technology
Background:
- The Wireless Stimulation Endocardially for CRT (WiSE-CRT) system offers leadless cardiac resynchronization therapy (CRT) for dyssynchronous heart failure (HF).
- Previous studies confirmed the safety and efficacy of WiSE-CRT, but its cost-effectiveness remained unevaluated.
Purpose of the Study:
- To conduct a cost-effectiveness evaluation of the WiSE-CRT system for heart failure treatment.
- To assess the economic viability of leadless CRT compared to existing therapies.
Main Methods:
- A cohort-based economic model with a "proportion in state" structure was utilized.
- Quality-adjusted life year (QALY) differences were quantified.
- Scenario and sensitivity analyses were performed to address parameter uncertainty.
Main Results:
- The WiSE-CRT system is likely cost-effective over a lifetime horizon at a £20,000 QALY threshold, yielding a net monetary benefit (NMB) of £3781 per QALY.
- Cost-effectiveness diminishes with time horizons under 10 years.
- Average system battery life significantly impacts overall cost-effectiveness.
Conclusions:
- The WiSE-CRT system presents a favorable economic case for indicated heart failure patients.
- Prioritizing advancements in battery technology is crucial for maximizing cost-effectiveness, especially under financial constraints in healthcare systems.
