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Preliminary report on the cost effectiveness of ventricular assist devices

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  • Artificial Heart (Clinical)
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Abstract

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 < 0.05). The cost of VAD implantation surgery was 313,282 ± 25,275 (ΔUS$/year) on the basis of medical reimbursement bills associated with therapeutic interventions. The calculated result of CEA was 364,501 ± 190,599 (ΔUS$/QALY). The improvement in the utility score was greater for implantable versus extracorporeal VADs (0.233 ± 0.534 vs. 0.371 ± 0.238) and ICER was 303,104 (ΔUS$/ΔQALY). Furthermore, when we estimated CEA for 36 months, the expected baseline value was 102,712 (US$/QALY). Therefore, VAD implantation surgery was cost effective considering the disease specificities.

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Acknowledgments

This study was structured on and funded by the Japanese Society for Medical Economics of Coronary Vascular Disease (JEC).

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Authors and Affiliations

  1. Department of Health Care Economics and Industrial Policy, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Tomoyuki Takura

  2. Department of Therapeutic Strategy for Heart Failure, Faculty of Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Shunei Kyo

  3. Department of Cardiovascular Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Minoru Ono

  4. Department of Cardiovascular Surgery, Clinical Medicine, Faculty of Medical Science, Kyushu University, Fukuoka, Japan

    Ryuji Tominaga & Yoshihisa Tanoue

  5. Department of Cardiovascular Surgery, Graduate School of Medicine, Osaka University, Suita, Japan

    Shigeru Miyagawa & Yoshiki Sawa

Authors
  1. Tomoyuki Takura
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  2. Shunei Kyo
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  3. Minoru Ono
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  4. Ryuji Tominaga
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  5. Shigeru Miyagawa
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  6. Yoshihisa Tanoue
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  7. Yoshiki Sawa
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Correspondence to Tomoyuki Takura.

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Conflict of interest

Tomoyuki Takura and Yoshiki Sawa received research funding from Terumo Co., Ltd. and Nipro Co., Ltd. Minoru Ono is advisory role of Sunmedical Co., Ltd. and he received research funding from Sunmedical Co., Ltd. The other authors declare that they have no conflict of interest.

Additional information

This article is from a study group of the Japanese Society for Medical Economics of Coronary Vascular Disease (JEC), Ventricular Assist Device Working Study Group.

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Takura, T., Kyo, S., Ono, M. et al. Preliminary report on the cost effectiveness of ventricular assist devices. J Artif Organs 19, 37–43 (2016). https://doi.org/10.1007/s10047-015-0858-5

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  • DOI: https://doi.org/10.1007/s10047-015-0858-5

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