Preliminary report on the cost effectiveness of ventricular assist devices

• Published in: Journal of artificial organs 2016-03, Vol.19 (1), p.37-43
• Main Authors: Takura, Tomoyuki, Kyo, Shunei, Ono, Minoru, Tominaga, Ryuji, Miyagawa, Shigeru, Tanoue, Yoshihisa, Sawa, Yoshiki
• Format: Article
• Language: English
• Subjects: Adult; Biomedical Engineering and Bioengineering; Cardiac Surgery; Cardiomyopathy, Dilated - economics; Cardiomyopathy, Dilated - surgery; Cardiomyopathy, Hypertrophic - economics; Cardiomyopathy, Hypertrophic - surgery; Cost-Benefit Analysis; Female; Heart-Assist Devices - economics; Humans; Male; Markov chains; Medicine; Medicine & Public Health; Middle Aged; Nephrology; Original Article; Quality-Adjusted Life Years
• ISSN: 1434-7229; 1619-0904
• DOI: 10.1007/s10047-015-0858-5

The aim of the present study was to perform a cost-effectiveness analysis (CEA) of ventricular assist devices (VAD) implantation surgery in the Japanese medical reimbursement system. The study group consisted of thirty-seven patients who had undergone VAD implantation surgery for dilated cardiomyopathy ( n  = 25; 67.6 %) or hypertrophic cardiomyopathy ( n  = 4; 10.8 %), and others ( n  = 8; 21.6 %). Quality-adjusted life years (QALYs) were calculated using the utility score and years of life. Medical reimbursement bills were chosen as cost indices. The observation period was the 12-month period after surgery. Then, the incremental cost-effectiveness ratio was calculated according to the VAD type. In addition, the prognosis after 36 months was estimated on the basis of the results obtained using the Markov chain model. The mean preoperative INTERMACS profile score was 2.35 ± 0.77. Our results showed that the utility score, which indicates the effectiveness of VAD implantation surgery, improved by 0.279 ± 0.188 (ΔQALY, p