tal budget impact with this new procedure incorporation under the SUS perspective. Methods: The BIA was based on a Markov model with quarterly cycles and 5-year time horizon in order to predict clinical and economic outcomes in a scenario with TAVI incorporation compared to the actual scenario -drug therapy (amiodarone, furosemide and digoxin) with or without aortic balloon valvoplasty. Epidemiological data were obtained from DATASUS and survival was extrapolated from PARTNER cohort B trial by using a Weibull distribution. Resource use, also gathered from this trial, included early perioperative complications (30 days) and late events (rehospitalization, dialysis, stroke, pacemaker implantation and major vascular complications). Costs were taken from the official Brazilian public official lists (DATASUS and BPS). Market-share data was obtained from Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista. Results: The estimated number of Brazilian patients eligible for SSVS treatment was 795, 922, 1,180, 1,335 and 1,402 respectively for years 1-5 of analysis. Compared to the current scenario, the inclusion of TAVI procedure with a 13% market share during the analysis period shows an additional budget through year 1-5 of 3.5M, 5.0M, 6.7M, 8.1M and 9.4M, consecutively. ConClusions: The incremental budget impact to include TAVI as a treatment option in the Brazilian Public Healthcare System for SSVS high-risk patients was estimated to be USD 65 million in 5 years. PCV14 Análise De imPACto orçAmentário Do oClusor sePtAl PerCutâneo PArA o FeChAmento De ComuniCAção interAtriAl (CiA) Do tiPo ostium seCunDum
CARDIOLOGY P1 Impact of peroperative administration of steroid over inflammatory response and pulmonary dysfunction following cardiac surgery
utilization; ii) large variability in prices and availability of data across jurisdictions; iii) rapidly evolving costs in parallel with technological developments; iv) broader impact of medical device beyond clinical effectiveness; v) multiple application across different clinical areas; vi) differences between the published price and actual cost of testing/diagnostics; vii) differences in procurement and reimbursement mechanisms across jurisdictions; viii) reduced confidence in results of the economic evaluation. ConClusions: This case study highlights key challenges in determining and measuring appropriate cost information when conducting economic evaluations of non-drug technologies in Canada, although this may not be unique to Canada. In the absence of good cost information, following appropriate guidance and exploring the parameter values in sensitivity analyses is required.
Premier database (2011)(2012) and augmented with the published literature. All costs were adjusted to 2013 dollars. The model estimated the costs associated with the following utilization outcomes: procedure time, transfusion rate, intensive care unit (ICU) length of stay (LOS), and general ward LOS. The following adverse events were considered: myocardial infarction, respiratory failure, acute renal failure, stroke/TIA, and second endovascular procedure within 12 months of the initial procedure. Sensitivity analysis was performed to assess the impact of imputed data, and one-way sensitivity analysis was performed for each parameter. Results: The expected costs for a hospital related to the above utilization and adverse event were $8,463 for Medtronic's stent graft system and $11,380 for the Competition. Fifty-six percent of the $2,917 difference was attributable to improved utilization associated with Medtronic's stent graft compared to the Competition. Adverse events and secondary endovascular procedures accounted for 25% and 19% of the difference, respectively. These results were robust to alternative sensitivity analyses. ConClusions: This analysis suggested that Medtronic's current stent graft is associated with cost savings compared to Competition for the above parameters. Future research is necessary to examine if these results are maintained based upon a head-to-head clinical study of EVAR stent systems.
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