Cost of 1-year left ventricular assist device destination therapy in chronic heart failure: a comparison with heart transplantation.

IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Acta Clinica Belgica Pub Date : 2014-06-01 Epub Date: 2014-03-20 DOI:10.1179/2295333714Y.0000000017
W Droogne, S Jacobs, K Van den Bossche, J Verhoeven, R R Bostic, J Vanhaecke, J Van Cleemput, F Rega, B Meyns
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引用次数: 11

Abstract

Objective: To analyse overall cost involved with destination therapy (DT) in comparison to transplantation (HTX) and bridging to transplantation.

Methods: Three groups of patients at one hospital were considered for this cost analysis: (1) patients included in the BENEMACS study starting May 2009 (n = 6); (2) all patients from May 2009 till May 2010 undergoing heart transplantation (n = 19); or (iii) undergoing Heartmate II implantation as a bridge to transplant (n = 13). Patients undergoing bridging were more sick (lower Intermacs class). DT patients were older (64±8 years). Cost was derived from actual hospital invoices, device, organ procurement and medical cost, and follow-up care during 1 year from implantation. Costs are presented in euro, by their mean values and standard deviation.

Results: One-year survivals were 83, 84, and 77%, respectively, for DT, HTX, and bridging. Costs for initial and re-hospitalizations were not different between groups. Costs for medical follow-up and medication were significantly higher for transplanted patients. The 1-year total cost was €85 531±19 823 for HTX, €125 108±32 399 for bridging, and €137 068±29 007 for DT. As 42% of the transplanted patients were bridged, the cost of the medical pathway HTX was €138 076±19 823. Assuming a 5-year survival and a similar yearly follow-up cost, the average cost per year is €42 153 for HTX, €53 637 for transplantation including the bridging cost, and €47 487 for DT.

Conclusion: Direct transplantation without bridging is the most cost-efficient treatment. The cost per patient per year for DT is similar to HTX considering its bridging activity.

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慢性心力衰竭1年左心室辅助装置终点治疗的费用:与心脏移植的比较。
目的:分析目的治疗(DT)与移植(HTX)和移植桥接治疗的总成本。方法:对同一家医院的三组患者进行成本分析:(1)2009年5月开始纳入BENEMACS研究的患者(n = 6);(2) 2009年5月至2010年5月接受心脏移植的患者(n = 19);或(iii)接受心脏伴侣II型植入作为移植的桥梁(n = 13)。接受桥接治疗的患者病情加重(Intermacs分级较低)。DT患者年龄较大(64±8岁)。费用来源于医院实际发票、器械、器官采购和医疗费用以及植入后1年内的随访护理。成本按其平均值和标准差以欧元表示。结果:DT、HTX和桥接的1年生存率分别为83,84和77%。初次住院和再次住院的费用在两组之间没有差异。移植患者的医疗随访和药物费用明显较高。HTX的1年总成本为€85 531±19 823,桥接为€125 108±32 399,DT为€137 068±29 007。42%的移植患者进行了桥接,HTX医疗路径的费用为€138 076±19 823。假设5年生存期和相似的年度随访成本,HTX每年的平均成本为42 153欧元,移植(包括桥接费用)为53 637欧元,DT为47 487欧元。结论:无桥接直接移植是最经济有效的治疗方法。考虑到其桥接活性,DT每年每位患者的费用与HTX相似。
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来源期刊
Acta Clinica Belgica
Acta Clinica Belgica MEDICINE, GENERAL & INTERNAL-
CiteScore
3.50
自引率
0.00%
发文量
44
期刊介绍: Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine primarily publishes papers on clinical medicine, clinical chemistry, pathology and molecular biology, provided they describe results which contribute to our understanding of clinical problems or describe new methods applicable to clinical investigation. Readership includes physicians, pathologists, pharmacists and physicians working in non-academic and academic hospitals, practicing internal medicine and its subspecialties.
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