Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina

Autores
Alcaraz, Andrea; Pichón-riviere, Andres; Rojas Roque, Carlos; González, Juan Martín; Prina, Daniela Luciana; Solioz, Germán; Augustovski, Federico Ariel; Palacios, Alfredo
Año de publicación
2022
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background Centrifugal-flow pumps are novel treatment options for patients with advanced heart failure (HF). This study estimated the incremental cost-effectiveness ratio (ICER) of centrifugal-flow pumps for patients with advanced HF in Argentina. Methods Two Markov models were developed to estimate the cost-effectiveness of a centrifugal-flow pump as destination therapy (DT) in patients with contraindication for heart transplantation, and as bridge-to-transplant (BTT), with a lifetime horizon using the third-party payer Social Security (SS) and Private Sector (PS) perspectives. Clinical, epidemiological, and quality-adjusted life years (QALY) parameters were retrieved from the literature. Direct medical costs were estimated through a micro-costing approach (exchange rate USD 1 = ARS 59.95). Results The centrifugal-flow pump as a DT increased the per patient QALYs by 3.5 and costs by ARS 8.1 million in both the SS and PS, with an ICER of ARS 2.3 million per QALY. Corresponding values for a centrifugal-flow pump as BTT were 0.74 QALYs and more than ARS 8 million, yielding ICERs of ARS 11 million per QALY (highly dependent on waiting times). For the 1, 3, and 5 GDP per QALY thresholds, the probability of a centrifugal-flow pump to be cost-effective for DT/BTT was around 2%/0%, 40%/0%, and 80%/1%, respectively. Conclusion The centrifugal-flow pump prolongs life and improves the quality of life at significantly higher costs. As in Argentina there is no current explicit cost-effectiveness threshold, the final decision on reimbursement will depend on the willingness to pay in each subsector. Nevertheless, the centrifugal-flow pump as a DT was more cost-effective than as a BTT.
Fil: Alcaraz, Andrea. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Pichón-riviere, Andres. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Rojas Roque, Carlos. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: González, Juan Martín. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Prina, Daniela Luciana. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Solioz, Germán. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Augustovski, Federico Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Palacios, Alfredo. Instituto de Efectividad Clínica y Sanitaria; Argentina
Materia
HEALTH ECONOMICS
CARDIAC TRANSPLANTATION
HEART FAILURE
COST-EFFECTIVENESS ANALYSIS
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/218165
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/218165
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in ArgentinaAlcaraz, AndreaPichón-riviere, AndresRojas Roque, CarlosGonzález, Juan MartínPrina, Daniela LucianaSolioz, GermánAugustovski, Federico ArielPalacios, AlfredoHEALTH ECONOMICSCARDIAC TRANSPLANTATIONHEART FAILURECOST-EFFECTIVENESS ANALYSIShttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Background Centrifugal-flow pumps are novel treatment options for patients with advanced heart failure (HF). This study estimated the incremental cost-effectiveness ratio (ICER) of centrifugal-flow pumps for patients with advanced HF in Argentina. Methods Two Markov models were developed to estimate the cost-effectiveness of a centrifugal-flow pump as destination therapy (DT) in patients with contraindication for heart transplantation, and as bridge-to-transplant (BTT), with a lifetime horizon using the third-party payer Social Security (SS) and Private Sector (PS) perspectives. Clinical, epidemiological, and quality-adjusted life years (QALY) parameters were retrieved from the literature. Direct medical costs were estimated through a micro-costing approach (exchange rate USD 1 = ARS 59.95). Results The centrifugal-flow pump as a DT increased the per patient QALYs by 3.5 and costs by ARS 8.1 million in both the SS and PS, with an ICER of ARS 2.3 million per QALY. Corresponding values for a centrifugal-flow pump as BTT were 0.74 QALYs and more than ARS 8 million, yielding ICERs of ARS 11 million per QALY (highly dependent on waiting times). For the 1, 3, and 5 GDP per QALY thresholds, the probability of a centrifugal-flow pump to be cost-effective for DT/BTT was around 2%/0%, 40%/0%, and 80%/1%, respectively. Conclusion The centrifugal-flow pump prolongs life and improves the quality of life at significantly higher costs. As in Argentina there is no current explicit cost-effectiveness threshold, the final decision on reimbursement will depend on the willingness to pay in each subsector. Nevertheless, the centrifugal-flow pump as a DT was more cost-effective than as a BTT.Fil: Alcaraz, Andrea. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Pichón-riviere, Andres. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Rojas Roque, Carlos. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: González, Juan Martín. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Prina, Daniela Luciana. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Solioz, Germán. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Augustovski, Federico Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Palacios, Alfredo. Instituto de Efectividad Clínica y Sanitaria; ArgentinaPublic Library of Science2022-08info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/218165Alcaraz, Andrea; Pichón-riviere, Andres; Rojas Roque, Carlos; González, Juan Martín; Prina, Daniela Luciana; et al.; Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina; Public Library of Science; Plos One; 17; 8 August; 8-2022; 1-181932-6203CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/doi/10.1371/journal.pone.0271519info:eu-repo/semantics/altIdentifier/url/https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0271519info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T10:12:52Zoai:ri.conicet.gov.ar:11336/218165instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 10:12:53.241CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina
title Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina
spellingShingle Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina
Alcaraz, Andrea
HEALTH ECONOMICS
CARDIAC TRANSPLANTATION
HEART FAILURE
COST-EFFECTIVENESS ANALYSIS
title_short Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina
title_full Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina
title_fullStr Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina
title_full_unstemmed Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina
title_sort Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina
dc.creator.none.fl_str_mv Alcaraz, Andrea
Pichón-riviere, Andres
Rojas Roque, Carlos
González, Juan Martín
Prina, Daniela Luciana
Solioz, Germán
Augustovski, Federico Ariel
Palacios, Alfredo
author Alcaraz, Andrea
author_facet Alcaraz, Andrea
Pichón-riviere, Andres
Rojas Roque, Carlos
González, Juan Martín
Prina, Daniela Luciana
Solioz, Germán
Augustovski, Federico Ariel
Palacios, Alfredo
author_role author
author2 Pichón-riviere, Andres
Rojas Roque, Carlos
González, Juan Martín
Prina, Daniela Luciana
Solioz, Germán
Augustovski, Federico Ariel
Palacios, Alfredo
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv HEALTH ECONOMICS
CARDIAC TRANSPLANTATION
HEART FAILURE
COST-EFFECTIVENESS ANALYSIS
topic HEALTH ECONOMICS
CARDIAC TRANSPLANTATION
HEART FAILURE
COST-EFFECTIVENESS ANALYSIS
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Background Centrifugal-flow pumps are novel treatment options for patients with advanced heart failure (HF). This study estimated the incremental cost-effectiveness ratio (ICER) of centrifugal-flow pumps for patients with advanced HF in Argentina. Methods Two Markov models were developed to estimate the cost-effectiveness of a centrifugal-flow pump as destination therapy (DT) in patients with contraindication for heart transplantation, and as bridge-to-transplant (BTT), with a lifetime horizon using the third-party payer Social Security (SS) and Private Sector (PS) perspectives. Clinical, epidemiological, and quality-adjusted life years (QALY) parameters were retrieved from the literature. Direct medical costs were estimated through a micro-costing approach (exchange rate USD 1 = ARS 59.95). Results The centrifugal-flow pump as a DT increased the per patient QALYs by 3.5 and costs by ARS 8.1 million in both the SS and PS, with an ICER of ARS 2.3 million per QALY. Corresponding values for a centrifugal-flow pump as BTT were 0.74 QALYs and more than ARS 8 million, yielding ICERs of ARS 11 million per QALY (highly dependent on waiting times). For the 1, 3, and 5 GDP per QALY thresholds, the probability of a centrifugal-flow pump to be cost-effective for DT/BTT was around 2%/0%, 40%/0%, and 80%/1%, respectively. Conclusion The centrifugal-flow pump prolongs life and improves the quality of life at significantly higher costs. As in Argentina there is no current explicit cost-effectiveness threshold, the final decision on reimbursement will depend on the willingness to pay in each subsector. Nevertheless, the centrifugal-flow pump as a DT was more cost-effective than as a BTT.
Fil: Alcaraz, Andrea. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Pichón-riviere, Andres. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Rojas Roque, Carlos. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: González, Juan Martín. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Prina, Daniela Luciana. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Solioz, Germán. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Augustovski, Federico Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Palacios, Alfredo. Instituto de Efectividad Clínica y Sanitaria; Argentina
description Background Centrifugal-flow pumps are novel treatment options for patients with advanced heart failure (HF). This study estimated the incremental cost-effectiveness ratio (ICER) of centrifugal-flow pumps for patients with advanced HF in Argentina. Methods Two Markov models were developed to estimate the cost-effectiveness of a centrifugal-flow pump as destination therapy (DT) in patients with contraindication for heart transplantation, and as bridge-to-transplant (BTT), with a lifetime horizon using the third-party payer Social Security (SS) and Private Sector (PS) perspectives. Clinical, epidemiological, and quality-adjusted life years (QALY) parameters were retrieved from the literature. Direct medical costs were estimated through a micro-costing approach (exchange rate USD 1 = ARS 59.95). Results The centrifugal-flow pump as a DT increased the per patient QALYs by 3.5 and costs by ARS 8.1 million in both the SS and PS, with an ICER of ARS 2.3 million per QALY. Corresponding values for a centrifugal-flow pump as BTT were 0.74 QALYs and more than ARS 8 million, yielding ICERs of ARS 11 million per QALY (highly dependent on waiting times). For the 1, 3, and 5 GDP per QALY thresholds, the probability of a centrifugal-flow pump to be cost-effective for DT/BTT was around 2%/0%, 40%/0%, and 80%/1%, respectively. Conclusion The centrifugal-flow pump prolongs life and improves the quality of life at significantly higher costs. As in Argentina there is no current explicit cost-effectiveness threshold, the final decision on reimbursement will depend on the willingness to pay in each subsector. Nevertheless, the centrifugal-flow pump as a DT was more cost-effective than as a BTT.
publishDate 2022
dc.date.none.fl_str_mv 2022-08
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/218165
Alcaraz, Andrea; Pichón-riviere, Andres; Rojas Roque, Carlos; González, Juan Martín; Prina, Daniela Luciana; et al.; Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina; Public Library of Science; Plos One; 17; 8 August; 8-2022; 1-18
1932-6203
CONICET Digital
CONICET
url http://hdl.handle.net/11336/218165
identifier_str_mv Alcaraz, Andrea; Pichón-riviere, Andres; Rojas Roque, Carlos; González, Juan Martín; Prina, Daniela Luciana; et al.; Cost-effectiveness of a centrifugal-flow pump for patients with advanced heart failure in Argentina; Public Library of Science; Plos One; 17; 8 August; 8-2022; 1-18
1932-6203
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
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info:eu-repo/semantics/altIdentifier/url/https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0271519
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Public Library of Science
publisher.none.fl_str_mv Public Library of Science
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
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reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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