Real-world cost effectiveness of MitraClip combined with Medical Therapy Versus Medical therapy alone in patients with moderate or severe mitral regurgitation

International Journal of Cardiology
Patrizio ArmeniFrancesco Maisano

Abstract

We evaluated the real-world cost-effectiveness of the MitraClip system (Abbott Vascular Inc., Menlo Park, CA) plus medical therapy for patients with moderate/severe mitral regurgitation, as compared with medical therapy (MT) alone. Clinical records of patients with moderate to severe functional mitral regurgitation treated with MitraClip (N=232) or with MT (N=151) were collected and outcome analyzed with propensity score adjustment to reduce selection bias. Twelve-month outcomes were modeled over a lifetime horizon to conduct a cost-effectiveness analysis, in the payer's perspective. Costs and benefits were discounted at an annual rate of 3.5%. After propensity score adjustment, the average treatment effect was -9.5% probability of dying at 12months and, following lifetime modeling, 3.35±0.75 incremental life years and 3.01±0.57 incremental quality-adjusted life years. MitraClip contributed to a higher decrease in re-hospitalizations at 12months (difference=-0.54±0.08) and generated a more likely improvement in the New York Heart Association (NYHA) class at 12months versus NYHA at enrollment. Incremental costs, adapted to five possible scenarios, ranged from 14,493 to 29,795 € contributing to an incremental cost-effectiveness r...Continue Reading

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Citations

Feb 1, 2017·Health Economics·Rosanna TarriconeValentina Prevolnik Rupel
Jan 13, 2018·European Heart Journal. Quality of Care & Clinical Outcomes·Fotini GialamaNikolaos Maniadakis
Aug 9, 2017·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Christos IliadisRoman Pfister
Aug 31, 2018·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Maurizio TaramassoFrancesco Maisano
Sep 5, 2018·European Journal of Heart Failure·Mirjam KeßlerSinisa Markovic
Sep 2, 2016·European Respiratory Review : an Official Journal of the European Respiratory Society·Rosanna TarriconePatrizio Armeni
Apr 3, 2019·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Konstantinos MarmagkiolisMehmet Cilingiroglu
Jul 5, 2018·Frontiers in Cardiovascular Medicine·Barbara E StähliAlexander Lauten
Sep 14, 2018·Circulation Journal : Official Journal of the Japanese Circulation Society·Ching-Wei LeeKuo-Piao Chung
Nov 26, 2019·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Marco ZimarinoCorrado Tamburino

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