+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Comparative cost-effectiveness of the HeartWare versus HeartMate II left ventricular assist devices used in the United Kingdom National Health Service bridge-to-transplant program for patients with heart failure



Comparative cost-effectiveness of the HeartWare versus HeartMate II left ventricular assist devices used in the United Kingdom National Health Service bridge-to-transplant program for patients with heart failure



Journal of Heart and Lung Transplantation 33(4): 350-358



Patients with advanced heart failure may receive a left ventricular assist device (LVAD) as part of a bridge-to-transplant (BTT) strategy. The United Kingdom National Health Service (UK NHS) has financed a BTT program in which the predominant LVADs used have been the HeartMate II (HM II; Thoratec, Pleasanton, CA) and HeartWare (HW; HeartWare International, Inc. Framingham, MA). We aimed to compare the cost-effectiveness of the use of these within the NHS program. Individual patient data from the UK NHS Blood and Transplant Data Base were analyzed with Kaplan-Meier and competing outcomes methodologies. Outcomes were time to death, time to heart transplant (HT), and cumulative incidences of HT, death on LVAD support, and LVAD explantation. A semi-Markov multistate economic model was built to assess cost-effectiveness. The perspective was from the NHS, discount rates were 3.5%. Outcomes were quality-adjusted life-years (QALYs) and incremental cost (2011 prices in GB£) per QALY (ICER) for HW vs HM II. Survival was better with HW support than with HM II. Cumulative incidence of HT was low for both groups (11% at ~2 years). HW patients accrued 4.99 lifetime QALYs costing £258,913 ($410,970), HM II patients accrued 3.84 QALYs costing £231,871 ($368,048); deterministic and probabilistic ICERs for HW vs HM II were £23,530 ($37,349) and £20,799 ($33,014), respectively. Patients In the UK BTT program who received the HW LVAD had a better clinical outcome than those who received the HM II, and the HW was more cost-effective. This result needs to be reassessed in a randomized controlled trial comparing the 2 devices.

(PDF emailed within 0-6 h: $19.90)

Accession: 052210905

Download citation: RISBibTeXText

PMID: 24582838

DOI: 10.1016/j.healun.2014.01.003


Related references

Cost-effectiveness of left ventricular assist devices (LVADs) for patients with advanced heart failure: analysis of the British NHS bridge to transplant (BTT) program. International Journal of Cardiology 171(3): 338-345, 2014

Effect of Preoperative Small Left Ventricle on Patients with Chronic Heart Failure Undergoing Implantation of Long-Term Continuous Flow Ventricular Assist Devices: Comparative Analysis of HeartMate II and HeartWare Devices. Journal of Heart and Lung Transplantation 36(4): S340-S341, 2017

HeartWare and HeartMate II left ventricular assist devices as bridge to transplantation: a comparative analysis. Annals of Thoracic Surgery 97(2): 506-512, 2014

Cost-Effectiveness Comparison of Intra Aortic Balloon Pump versus Left Ventricular Assist Devices as Bridge to Heart Transplant (BTT) Strategies. Journal of Heart and Lung Transplantation 35(4): S272-S273, 2016

Clinical effectiveness and cost-effectiveness of second- and third-generation left ventricular assist devices as either bridge to transplant or alternative to transplant for adults eligible for heart transplantation: systematic review and cost-effectiveness model. Health Technology Assessment 17(53): 1-499, V-Vi, 2014

PP02Cost-Effectiveness of New left Ventricular Assist Devices (LVADS) for Patients with advanced Heart Failure: Analysis of the UK NHS Bridge to Transplant (BTT) programme. Journal of Epidemiology & Community Health 67(Suppl 1): A49.2-A49, 2013

Clinical and cost-effectiveness of left ventricular assist devices as a bridge to heart transplantation for people with end-stage heart failure: a systematic review and economic evaluation. European Heart Journal 27(24): 2929-2938, 2006

Laparoscopic sleeve gastrectomy in patients with heart failure and left ventricular assist devices as a bridge to transplant. Surgery for Obesity and Related Diseases, 2018

Accuracy of Seattle Heart Failure Model and HeartMate II Risk Score in Non-Inotrope-Dependent Advanced Heart Failure Patients: Insights From the ROADMAP Study (Risk Assessment and Comparative Effectiveness of Left Ventricular Assist Device and Medical Management in Ambulatory Heart Failure Patients). Circulation. Heart Failure 10(5): -, 2017

Daily costs reduced for status 1 heart transplant patients following bridge with Heartmate left ventricular assist device. Journal of Heart & Lung Transplantation 16(1): 57, 1997

Cost-Effectiveness of Left Ventricular Assist Devices in Ambulatory Patients With Advanced Heart Failure. Jacc. Heart Failure 5(2): 110-119, 2016

Implantation of the HeartMate II and HeartWare left ventricular assist devices in patients with duchenne muscular dystrophy: lessons learned from the first applications. Asaio Journal 60(2): 246-248, 2014

Continuous flow left ventricular assist devices (LVADs) effectively improve pulmonary hemodynamics in bridge-to-transplant patients with end-stage heart failure. 2007

Ambient hemolysis and activation of coagulation is different between HeartMate II and HeartWare left ventricular assist devices. Journal of Heart and Lung Transplantation 33(1): 80-87, 2014

Cost-effectiveness of the implantable HeartMate II left ventricular assist device for patients awaiting heart transplantation. Journal of Heart and Lung Transplantation 31(5): 450-458, 2012