シヌスノード機能不全に対する心室ペースと比較して,二重室ペースの費用対効果
Stéphane Rinfret1, David J Cohen, Gervasio A Lamas
1Department of Medicine, Centre Hospitalier de l'Université de Montréal (CHUM), University of Montreal, Montreal, Canada.
Circulation
|January 5, 2005
まとめ
デュアル・チャンバー・ペーシングは,シヌス症候群の患者の生活の質を改善します. この高度なペースメソッドは,長期的な費用対効果が高く,患者の治療結果を改善するために受け入れられる選択肢です.
科学分野:
- 心臓病学 心臓病学
- 健康経済学 医療経済学
- 医療技術評価 医療技術評価について
背景:
- 病気シヌス症候群 (SSS) の患者はしばしばペースメーカーを必要とします.
- デュアル・チャンバー・ペーシング (DCP) は,シングル・チャンバー・ベントリキュラー・ペーシング (VVI) よりも,生活の質の向上を含む利点を提供しています.
- SSSのためのVVIと比較してDCPの費用対効果は,依然として重要な考慮事項です.
研究 の 目的:
- シヌス症候群の患者で二重室ペースのペースと心室ペースのコスト効果を評価する.
- 患者の生涯にわたって二重室ペースの長期的な費用対効果を予測する.
主な方法:
- 2010年の患者によるランダム化試験の4年間のデータを活用した.
- ライフタイム予測のために,試験データで校正されたマルコフモデルを使用しました.
- 頑丈性を確保するために,1000件のブートストラップ分析と複数の感度分析を実施しました.
主要な成果:
- デュアルチャームペースは,最初の4年間で獲得した品質調整寿命年 (QALY) につき53,000ドルの増加コスト効率比 (ICER) を実証しました.
- ライフタイム・プロジェクションは,品質調整された平均寿命の大幅な増加を示し,獲得したQALYあたり約6,800ドルのICERを示した.
- 費用対効果は,ブートストラップと感度分析において一貫して観察され,DCPは,共通の支払い意欲の値のシミュレーションの90%以上で費用対効果的であった.
結論:
- デュアルチェンバペースは,ペースメーカーのインプラントを必要とするシヌス症候群の患者にとって費用対効果の高い戦略です.
- この技術は,一般的に受け入れられるコストで,品質調整された平均寿命を高めます.
- DCPは,SSS患者の長期的な結果を改善するための貴重な治療法である.
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