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Cost-effectiveness of cardiac resynchronization therapy: results from the CARE-HF trial

Cost-effectiveness of cardiac resynchronization therapy: results from the CARE-HF trial
Cost-effectiveness of cardiac resynchronization therapy: results from the CARE-HF trial
Aims

Whilst the CArdiac REsynchronization in Heart Failure (CARE-HF) trial has shown that cardiac resynchronization therapy (CRT) leads to reduced morbidity and mortality, the cost-effectiveness of this therapy remains uncertain. The aim of this study was to evaluate the incremental cost per quality adjusted life year (QALY) gained and incremental cost per life year gained of CRT plus medical therapy compared to medical therapy alone.

Methods and results

This prospective analysis based on intention to treat data from all patients enrolled in the CARE-HF trial at 82 clinical centres in 12 European countries. A total of 813 patients with New York Heart Association class III or IV heart failure due to left ventricular systolic dysfunction and cardiac dyssynchrony were randomized to CRT plus medical therapy (n=409) vs. medical therapy alone (n=404). During a mean follow-up of 29.4 months CRT was associated with increased costs (€4316, 95% CI: 1327–7485), survival (0.10 years, 95% CI: ?0.01–0.21), and QALYs (0.22, 95% CI: 0.13–0.32). The incremental cost-effectiveness ratio was €19?319 per QALY gained (95% CI: 5482–45?402) and €43?596 per life-year gained (95% CI: ?146?236–223?849). These results were sensitive to the costs of the device, procedure, and hospitalization.

Conclusion

Treatment with CRT appears cost-effective at the notional willingness to pay threshold of €29 400 (£20?000) per QALY gained.
cardiac resynchronization therapy, cost-effectiveness, CARE-HF, quality-adjusted life-year
0195-668X
2681-2688
Calvert, M.J.
27445ee6-2c4b-4033-9457-535b425dddb5
Freemantle, N.
76c59b7f-991b-4b1b-9ecc-c1ba3e282fb5
Yao, G.
d777f84c-cf3d-4fad-bbc1-ea01dec01695
Cleland, J.G.
d9bc3de3-2811-4314-805b-6f40892f4f09
Billingham, L.
88817da1-50c3-4863-8c72-25eabed45d4c
Daubert, J.C.
c605af47-38ee-4ac3-ab22-783b0ef08e16
Bryan, S.
4d0e46f3-c722-40d6-81ba-10fc3ed7e17b
Calvert, M.J.
27445ee6-2c4b-4033-9457-535b425dddb5
Freemantle, N.
76c59b7f-991b-4b1b-9ecc-c1ba3e282fb5
Yao, G.
d777f84c-cf3d-4fad-bbc1-ea01dec01695
Cleland, J.G.
d9bc3de3-2811-4314-805b-6f40892f4f09
Billingham, L.
88817da1-50c3-4863-8c72-25eabed45d4c
Daubert, J.C.
c605af47-38ee-4ac3-ab22-783b0ef08e16
Bryan, S.
4d0e46f3-c722-40d6-81ba-10fc3ed7e17b

Calvert, M.J., Freemantle, N., Yao, G., Cleland, J.G., Billingham, L., Daubert, J.C. and Bryan, S. (2005) Cost-effectiveness of cardiac resynchronization therapy: results from the CARE-HF trial. European Heart Journal, 26 (24), 2681-2688. (doi:10.1093/eurheartj/ehi662). (PMID:16284203)

Record type: Article

Abstract

Aims

Whilst the CArdiac REsynchronization in Heart Failure (CARE-HF) trial has shown that cardiac resynchronization therapy (CRT) leads to reduced morbidity and mortality, the cost-effectiveness of this therapy remains uncertain. The aim of this study was to evaluate the incremental cost per quality adjusted life year (QALY) gained and incremental cost per life year gained of CRT plus medical therapy compared to medical therapy alone.

Methods and results

This prospective analysis based on intention to treat data from all patients enrolled in the CARE-HF trial at 82 clinical centres in 12 European countries. A total of 813 patients with New York Heart Association class III or IV heart failure due to left ventricular systolic dysfunction and cardiac dyssynchrony were randomized to CRT plus medical therapy (n=409) vs. medical therapy alone (n=404). During a mean follow-up of 29.4 months CRT was associated with increased costs (€4316, 95% CI: 1327–7485), survival (0.10 years, 95% CI: ?0.01–0.21), and QALYs (0.22, 95% CI: 0.13–0.32). The incremental cost-effectiveness ratio was €19?319 per QALY gained (95% CI: 5482–45?402) and €43?596 per life-year gained (95% CI: ?146?236–223?849). These results were sensitive to the costs of the device, procedure, and hospitalization.

Conclusion

Treatment with CRT appears cost-effective at the notional willingness to pay threshold of €29 400 (£20?000) per QALY gained.

Full text not available from this repository.

More information

e-pub ahead of print date: 11 November 2005
Published date: December 2005
Keywords: cardiac resynchronization therapy, cost-effectiveness, CARE-HF, quality-adjusted life-year
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 365053
URI: https://eprints.soton.ac.uk/id/eprint/365053
ISSN: 0195-668X
PURE UUID: 189e2953-7be2-44ca-b371-eec8148963f5

Catalogue record

Date deposited: 19 May 2014 15:29
Last modified: 18 Jul 2017 02:25

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