Article type
Abstract
Abstract
Background: Heart failure (HF) poses a significant global health challenge, impacting millions of lives. End-stage heart failure (ESHF) presents a complex scenario with limited treatment options, including left ventricular assist devices (LVAD) and optimal medical therapy (OMT). This study aims to provide valuable insights into the cost-effectiveness of LVAD compared to OMT in the Indian context, addressing the economic implications and offering guidance for healthcare decision-makers.
Objective: To assess the cost-effectiveness of LVAD compared to OMT in adult patients with end-stage heart failure.
Methods: The study included all types of economic evaluations, systematic reviews, and randomized controlled trials. It focused on adults diagnosed with chronic end-stage heart failure. Outcomes were assessed in terms of the incremental cost-effectiveness ratio (ICER), net monetary benefit (NMB), and incremental quality-adjusted life year (QALY) over a 5-year period. The study adopted patient perspective and currency in INR.
Results: LVAD incurs higher costs ₹35,07,847.04 but offers better QALYs compared to OMT, resulting in an unfavourable ICER of ₹22,41,817.20 per QALY gained. Sensitivity analysis indicates higher costs with substantial benefits. The study underscores LVAD's potential for extended survival, urging nuanced decision-making considering both immediate costs and long-term patient well-being.
Conclusion: Despite the apparent cost disparity, the study highlights the justifiable rationale for considering LVAD due to its potential for extended and improved survival rates. Decision-makers must weigh immediate financial considerations against long-term patient well-being, recognizing the pivotal role of device costs. A detailed approach is essential, prioritizing broader health outcomes over conventional economic criteria.
Background: Heart failure (HF) poses a significant global health challenge, impacting millions of lives. End-stage heart failure (ESHF) presents a complex scenario with limited treatment options, including left ventricular assist devices (LVAD) and optimal medical therapy (OMT). This study aims to provide valuable insights into the cost-effectiveness of LVAD compared to OMT in the Indian context, addressing the economic implications and offering guidance for healthcare decision-makers.
Objective: To assess the cost-effectiveness of LVAD compared to OMT in adult patients with end-stage heart failure.
Methods: The study included all types of economic evaluations, systematic reviews, and randomized controlled trials. It focused on adults diagnosed with chronic end-stage heart failure. Outcomes were assessed in terms of the incremental cost-effectiveness ratio (ICER), net monetary benefit (NMB), and incremental quality-adjusted life year (QALY) over a 5-year period. The study adopted patient perspective and currency in INR.
Results: LVAD incurs higher costs ₹35,07,847.04 but offers better QALYs compared to OMT, resulting in an unfavourable ICER of ₹22,41,817.20 per QALY gained. Sensitivity analysis indicates higher costs with substantial benefits. The study underscores LVAD's potential for extended survival, urging nuanced decision-making considering both immediate costs and long-term patient well-being.
Conclusion: Despite the apparent cost disparity, the study highlights the justifiable rationale for considering LVAD due to its potential for extended and improved survival rates. Decision-makers must weigh immediate financial considerations against long-term patient well-being, recognizing the pivotal role of device costs. A detailed approach is essential, prioritizing broader health outcomes over conventional economic criteria.