The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2006
Cost-effectiveness of ventricular assist device use in the United Kingdom: results from the evaluation of ventricular assist device programme in the UK (EVAD-UK).
Оценочное исследованиеСтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Sharples Linda D, Dyer Matthew, Cafferty Fay, Demiris Nikolaos, Freeman Carol, Banner Nicholas R, Large Stephen R, Tsui Steven, Caine Noreen, Buxton Martin
Аннотация
BACKGROUND: The UK Department of Health funds ventricular assist device (VAD) implantation as a bridge to transplantation (BTT) at three centers. The cost-effectiveness of this program has not been established.
METHODS: All 70 VAD implants for BTT and a consecutive cohort of 71 inotrope-dependent transplant candidates, between April 2002 and December 2004, were prospectively monitored for survival, transplantation, quality of life and resource use. Costs and quality-adjusted life-years were estimated for these groups, and for a hypothetical scenario in which VAD patients would die within 30 days in the absence of the program.
RESULTS: Mean quality-adjusted life-years for a VAD patient was 3.27 at a lifetime cost of 173,841 pounds (316,078 US dollars). The majority of the cost was attributable to the VAD implant (63,830 pounds, 116,056 US dollars) and the initial hospital stay in the ITU and ward (14,500 pounds, 26,364 US dollars). Inotrope-dependent transplant candidates had mean quality-adjusted life-years of 4.99 at a lifetime cost of 130,905 pounds (238,011 US dollars). The worst clinical scenario resulted in a lifetime cost of 14,400 pounds (26,182 US dollars), based on 1 month in the ICU (mean 15 days). These figures were robust to a range of plausible assumptions.
CONCLUSIONS: A lifetime model based on current UK practice demonstrates that BTT VAD patients had significant quality-adjusted life-years, but treatment was expensive when compared with the worst clinical scenario. If device technology improves, costs are reduced, or referral practice changes, results should be re-assessed.
METHODS: All 70 VAD implants for BTT and a consecutive cohort of 71 inotrope-dependent transplant candidates, between April 2002 and December 2004, were prospectively monitored for survival, transplantation, quality of life and resource use. Costs and quality-adjusted life-years were estimated for these groups, and for a hypothetical scenario in which VAD patients would die within 30 days in the absence of the program.
RESULTS: Mean quality-adjusted life-years for a VAD patient was 3.27 at a lifetime cost of 173,841 pounds (316,078 US dollars). The majority of the cost was attributable to the VAD implant (63,830 pounds, 116,056 US dollars) and the initial hospital stay in the ITU and ward (14,500 pounds, 26,364 US dollars). Inotrope-dependent transplant candidates had mean quality-adjusted life-years of 4.99 at a lifetime cost of 130,905 pounds (238,011 US dollars). The worst clinical scenario resulted in a lifetime cost of 14,400 pounds (26,182 US dollars), based on 1 month in the ICU (mean 15 days). These figures were robust to a range of plausible assumptions.
CONCLUSIONS: A lifetime model based on current UK practice demonstrates that BTT VAD patients had significant quality-adjusted life-years, but treatment was expensive when compared with the worst clinical scenario. If device technology improves, costs are reduced, or referral practice changes, results should be re-assessed.