The University of Southampton
University of Southampton Institutional Repository

Clinical and cost-effectiveness of left ventricular assist devices as destination therapy for people with end-stage heart failure: a systematic review and economic evaluation

Clinical and cost-effectiveness of left ventricular assist devices as destination therapy for people with end-stage heart failure: a systematic review and economic evaluation
Clinical and cost-effectiveness of left ventricular assist devices as destination therapy for people with end-stage heart failure: a systematic review and economic evaluation
OBJECTIVES: The clinical and cost-effectiveness of left ventricular assist devices as destination therapy for people with end-stage heart failure is assessed through a systematic review and economic evaluation.

METHODS: Systematic review was performed of randomized controlled trials, quasiexperimental studies,case series, and case studies identified through searching eighteen electronic databases, bibliographies, and consultation with experts and manufacturers. Studies assessed survival, functional capacity, and quality of life. Cost effectiveness was assessed through a 5-year decision analytic model to estimate the incremental cost-effectiveness ratio for using left ventricular assist devices compared with usual care.

RESULTS: Six studies met the inclusion criteria, showing that left ventricular assist devices appear beneficial, improving survival and quality of life. Adverse events are a serious concern. The economic evaluation showed that left ventricular assist devices had a cost per quality adjusted life year of 170,616 pounds. Sensitivity analysis showed that the cost-effectiveness was not sensitive to changes in costs or utility.

CONCLUSIONS: Although left ventricular assist devices appear clinically effective as destination therapy, it is unlikely they will be cost-effective unless costs decrease or the benefits of their use increase.
heart failure, left ventricular assist devices, systematic review, economic evaluation, health technology assessment
0266-4623
261-268
Clegg, Andrew J.
838091f5-39df-4dbe-a369-675b26f2301b
Scott, David A.
19b5fd34-9974-4ae4-8be0-27a693639e20
Loveman, Emma
06ff1bf1-0189-4330-b22d-f5a917e9871d
Colquitt, Jill
741c69a3-d9e0-4f10-b457-e496541e7915
Royle, Pam
65edd3b7-b4cc-4563-9269-e7ebf23ef425
Bryant, Jackie
cd84de60-e9a2-4d7a-8ec6-6ca6276b12aa
Clegg, Andrew J.
838091f5-39df-4dbe-a369-675b26f2301b
Scott, David A.
19b5fd34-9974-4ae4-8be0-27a693639e20
Loveman, Emma
06ff1bf1-0189-4330-b22d-f5a917e9871d
Colquitt, Jill
741c69a3-d9e0-4f10-b457-e496541e7915
Royle, Pam
65edd3b7-b4cc-4563-9269-e7ebf23ef425
Bryant, Jackie
cd84de60-e9a2-4d7a-8ec6-6ca6276b12aa

Clegg, Andrew J., Scott, David A., Loveman, Emma, Colquitt, Jill, Royle, Pam and Bryant, Jackie (2007) Clinical and cost-effectiveness of left ventricular assist devices as destination therapy for people with end-stage heart failure: a systematic review and economic evaluation. International Journal of Technology Assessment in Health Care, 23 (2), 261-268. (doi:10.1017/S0266462307070353). (PMID:17493313)

Record type: Article

Abstract

OBJECTIVES: The clinical and cost-effectiveness of left ventricular assist devices as destination therapy for people with end-stage heart failure is assessed through a systematic review and economic evaluation.

METHODS: Systematic review was performed of randomized controlled trials, quasiexperimental studies,case series, and case studies identified through searching eighteen electronic databases, bibliographies, and consultation with experts and manufacturers. Studies assessed survival, functional capacity, and quality of life. Cost effectiveness was assessed through a 5-year decision analytic model to estimate the incremental cost-effectiveness ratio for using left ventricular assist devices compared with usual care.

RESULTS: Six studies met the inclusion criteria, showing that left ventricular assist devices appear beneficial, improving survival and quality of life. Adverse events are a serious concern. The economic evaluation showed that left ventricular assist devices had a cost per quality adjusted life year of 170,616 pounds. Sensitivity analysis showed that the cost-effectiveness was not sensitive to changes in costs or utility.

CONCLUSIONS: Although left ventricular assist devices appear clinically effective as destination therapy, it is unlikely they will be cost-effective unless costs decrease or the benefits of their use increase.

Full text not available from this repository.

More information

Published date: April 2007
Keywords: heart failure, left ventricular assist devices, systematic review, economic evaluation, health technology assessment
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 345700
URI: http://eprints.soton.ac.uk/id/eprint/345700
ISSN: 0266-4623
PURE UUID: 39e3ee8b-6e3d-48b6-b9ec-9f55889732c3
ORCID for David A. Scott: ORCID iD orcid.org/0000-0001-6475-8046

Catalogue record

Date deposited: 25 Feb 2013 14:50
Last modified: 13 Jun 2020 00:47

Export record

Altmetrics

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×