gained) over a 30-year time horizon. Sensitivity analyses were performed. ReSultS: Base-case results suggest that compared to ACEi, sacubitril/valsartan is associated with incremental costs of ₡3,385,614 and 0.53 QALYs gained, with an incremental cost-effectiveness ratio of ₡6,400,593 per QALY gained. Increased costs of pharmacological therapy were offset by reductions in hospitalization costs. All-cause-and CV-related mortality estimates were reduced at all time points. Expected survival estimates increased from 5.84 years for those receiving an ACEi to 6.45 years for those receiving sacubitril/valsartan. Overall, results were not sensitive to changes in model parameters; results were most sensitive to CV mortality estimates and treatment-effect duration. ConCluSionS: The Costa Rica-adapted model estimates suggest that sacubitril/valsartan represents a cost-effective intervention in the treatment of HFrEF (NYHA Class II-IV) versus ACEi, assuming a willingness-topay threshold of 3 times per capita GDP in Costa Rica (₡25,807,290). Consequently, sacubitril/valsartan represents reasonable value compared with other commonly accepted health care interventions.
S63ObjectiveS: To compare length of stay (LOS) and costs among patients undergoing procedures requiring closure of large bore arterial access using the Perclose ProGlide® Suture-Mediated Closure System (ProGlide) versus manual surgical cutdown (Cutdown) in a real-world setting. MethOdS: This retrospective study analyzed patients undergoing procedures that require arterial closure (Transcatheter Aortic Valve Replacement/Repair (TAVR), Endovascular Abdominal Aortic Aneurysm Repair (AAA), Thoracic Endovascular Aortic Repair (TAA), or Balloon Aortic Valvuloplasty (BAV)) from 2013 -2017 in the IBM Explorys Research Database. Patients receiving ProGlide during the procedure were directly matched and compared to patients treated by the same providers that were closed via manual surgical cutdown. The LOS for the procedure admission and procedure complications were assessed. Costs per day of admission were estimated using claims data from TAVR, AAA, TAA, or BAV procedure admissions in the Truven Health MarketScan Research Database. A generalized linear model was used to quantify the cost associated with differences in LOS. ReSultS: A total of 839 ProGlide patients and 839 matched Cutdown patients met the inclusion criteria. Proglide patients experienced lower rates of complications, including infection. Average LOS for ProGlide patients was nearly four days shorter than Cutdown patients (mean: 9.0 vs. 5.1 days; median: 7.0 vs. 3.0; p< 0.001). While controlling for index procedure, age, and gender, LOS was a significant predictor of costs, with each day associated with a 4% increase in total cost for the hospitalization (p< 0.05). Using the difference in median LOS, predicted total costs for the procedure admission were $20,599 lower among ProGlide patients compared to Cutdown. cOncluSiOnS: The use of Perclose ProGlide was associated with significantly shorter length of stay for the procedure admission compared to surgical Cutdown. Future analyses should focus on directly quantifying the cost-savings and patient benefit from lower complication rates and shortened LOS.
A353predictive value of 52% (95%CI, 37%-68%) and a negative predictive value of 97% (95%CI, 83%-100%). Results at 6-months follow-up were similar. Total mean medical costs per patient for PWU and CWU were € 11,302 and € 11, and € 12,670 and € 13,, respectively. The incremental costs were in favor of the PWU patients (€ 482 (6-months), € 1,105 (12-months)). Sensitivity analyses showed that the most influential parameters were hospitalization, treatment-related operations and cost of PET. ConClusions: The introduction of 18F-FDG PET in the diagnostic trajectory of laryngeal cancer patients with suspected recurrence after radiotherapy is feasible, safe and favorable from clinical and economic perspectives. PMD52The econoMic BurDen of carDiac coMPlicaTions of PercuTaneous coronary inTervenTion in englanD: an analysis of hosPiTal ePisoDe sTaTisTics
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