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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 |
Sutcliffe P, Connock M, Pulikottil-Jacob R, Kandala NB, Suri G, Gurung T, Grove A, Shyangdan D, Briscoe S, Maheswaran H, Clarke A |
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Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Sutcliffe P, Connock M, Pulikottil-Jacob R, Kandala NB, Suri G, Gurung T, Grove A, Shyangdan D, Briscoe S, Maheswaran H, Clarke A. 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 2013; 17(53) Authors' objectives To investigate for patients aged 16 years with advanced HF eligible for HT: (1) the clinical effectiveness and cost-effectiveness of second- and third-generation VADs used as BTT compared with medical management (MM); and (2) the clinical effectiveness and cost-effectiveness of second- and third-generation VADs used as an ATT in comparison with their use as BTT therapy. Authors' conclusions At 3 years, 10 years and lifetime the ICERs for VADs as BTT compared with MM are higher than generally applied willingness-to-pay thresholds in the UK, but at a lifetime time horizon they approximate threshold values used in end of life assessments. VADs as ATT have a reduced cost but cause reduced QALYs relative to BTT. Future research should direct attention towards two areas. First, how any future evaluations of second- or third-generation VADs might be conducted. For ethical reasons a RCT offering equal probability of HT for each group would not be feasible; future studies should fully assess costs, long-term patient survival, QoL, functional ability and adverse events, so that these may be incorporated into economic evaluation agreement on outcomes measures across future studies. Second, continuation of accurate data collection in the UK database to encompass QoL data and comparative assessment of performance with other international centres. Indexing Status Subject indexing assigned by NLM MeSH Age Factors; Cardiotonic Agents /economics /therapeutic use; Cost-Benefit Analysis; Great Britain; Heart Failure /mortality /therapy; Heart-Assist Devices /adverse effects /economicss; Models, Economic; Quality of Life; Quality-Adjusted Life Years; State Medicine; Technology Assessment, Biomedical Language Published English Country of organisation England English summary An English language summary is available. Address for correspondence NETSCC, Health Technology Assessment, Alpha House, University of Southampton Science Park, Southampton, SO16 7NS UK Tel: +44 23 8059 5586 Email: hta@hta.ac.uk AccessionNumber 32013000936 Date abstract record published 12/12/2013 |
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