Costs and benefits in patients with NYHA class III heart failure treated with CardioMEMS in Italy
DOI:
https://doi.org/10.33393/grhta.2024.3018Keywords:
Heart failure, MitraClip, NYHA class, Telemedicine, Value-based priceAbstract
Background: CardioMEMS is a device suitable for telemedicine that is currently being evaluated by the Regional Health Technology Assessment (HTA) Committee of Tuscany. Two detailed HTA reports are available in the specialized literature, the results of which need to be transferred to our regional setting. These decisions in Tuscany are made by the so-called Centro Operativo HTA.
Aim: To validate, with local cost-effectiveness data, the decision on CardioMEMS that will be made in the Tuscany region.
Methods: Two detailed international HTA reports were rearranged and adapted to our regional setting to generate a simplified analysis that could form the basis of our decision. Two willingness-to-pay (WTP) thresholds of €20,000/quality-adjusted life year (QALY) and €50,000/QALY were considered.
Results: Based on epidemiological and regulatory information, the target population in Tuscany for this device is 166 cases. The value-based price of CardioMEMS is estimated to be €4,332 and €16,662 at WTP thresholds of 20,000/QALY and 50,000/QALY, respectively. Its current price in Italy is €12,000.
Conclusion: In our region, the introduction of CardioMEMS is likely to be gradual, around 50 patients/year (or €0.60 million/year at current price). This example highlights the need to adapt the information published in the international literature to the local context in which the approval decision is made. In this context, simplified analyses are easier to apply than complex Markov models.
Downloads
References
Brugts JJ, Radhoe SP, Clephas PRD, et al; MONITOR-HF investigators. Remote haemodynamic monitoring of pulmonary artery pressures in patients with chronic heart failure (MONITOR-HF): a randomised clinical trial. Lancet. 2023;401(10394):2113-2123. https://doi.org/10.1016/S0140-6736(23)00923-6 PMID:37220768 DOI: https://doi.org/10.1016/S0140-6736(23)00923-6
Abraham WT, Adamson PB, Bourge RC, et al; CHAMPION Trial Study Group. Wireless pulmonary artery haemodynamic monitoring in chronic heart failure: a randomised controlled trial. Lancet. 2011;377(9766):658-666. https://doi.org/10.1016/S0140-6736(11)60101-3 PMID:21315441 DOI: https://doi.org/10.1016/S0140-6736(11)60101-3
Messori A, Romeo MR, Trippoli S. Remote monitoring in heart failure: inclusion of too many different studies in the same meta-analysis (Letter). JACC, 2024, in press. DOI 10.1016/j.jacc.2024.02.058
Cowie MR, Simon M, Klein L, Thokala P. The cost-effectiveness of real-time pulmonary artery pressure monitoring in heart failure patients: a European perspective. Eur J Heart Fail. 2017;19(5):661-669. PMID:28176424 https://doi.org/10.1002/ejhf.747 PMID:28176424 DOI: https://doi.org/10.1002/ejhf.747
Cowie MR, Thokala P, Ihara Z, Adamson PB, Angermann C. Real-time pulmonary artery pressure monitoring in heart failure patients: an updated cost-effectiveness analysis. ESC Heart Fail. 2023;10(5):3046-3054. PMID:37591524 https://doi.org/10.1002/ehf2.14496 PMID:37591524 DOI: https://doi.org/10.1002/ehf2.14496
Regione Toscana. Delibera N.947 del 27 Settembre 2016, Allegato 3, Tabella A, pag.4 (DRG 127, €3052). https://www.regione.toscana.it/bancadati/atti/Contenuto.xml?id=5127223&nomeFile=Delibera_n.947_del_27-09-2016-Allegato-3. Accessed December 2023.
Pradelli L, Iannazzo S, Zaniolo O. The cost effectiveness and cost utility of valsartan in chronic heart failure therapy in Italy: a probabilistic Markov model. Am J Cardiovasc Drugs. 2009;9(6):383-392. PMID:19929036 https://doi.org/10.2165/11315730-000000000-00000 PMID:19929036 DOI: https://doi.org/10.2165/11315730-000000000-00000
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2024 The authors
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Accepted 2024-02-27
Published 2024-05-02
