Congenital heart defect repair with ADAPT tissue engineered pericardium scaffold: An early-stage health economic model

Abstract

ObjectiveThe objective of this study was to evaluate the cost effectiveness of tissue engineered bovine tissue pericardium scaffold (CardioCel) for the repair of congenital heart defects in comparison with surgery using xenogeneic, autologous, and synthetic patches over a 40-year time horizon from the perspective of the UK National Health Service.MethodsA six-state Markov state-transition model to model natural history of disease and difference in the interventional effect of surgeries depending on patch type implanted. Patches differed regarding their probability of re-operation due to patch calcification, based on a systematic literature review. Transition probabilities were based on the published literature, other clinical inputs were based on UK registry data, and cost data were based on UK sources and the published literature. Incremental cost-effectiveness ratio (ICER) was determined as incremental costs per quality adjusted life years (QALY) gained. We used a 40-year analytic time-horizon and adopted the payer perspective. Comprehensive sensitivity analyses were performed.ResultsAccording to the model predictions, CardioCel was associated with reduced incidence of re-operation, increased QALY, and costs savings compared to all other patches. Cost savings were greatest compared to synthetic patches. Estimated cost savings associated with CardioCel were greatest within atrioventricular septal defect repair and lowest for ventricular septal defect repair. Based on our model, CardioCel relative risk for re-operations is 0.938, 0.956and 0.902 relative to xenogeneic, autologous, and synthetic patches, respectively.ConclusionCardioCel was estimated to increase health benefits and save cost when used during surgery for congenital heart defects instead of other patches.

Equine pericardium: a versatile alternative reconstructive material in congenital cardiac surgery

“…However, in Saudi Arabia the coast of the EP is comparable to BP (EP cost is 900 dollars and BP cost is 825 dollars). We agree with Veličković et al [ 20 ] that the rate of revision or reoperation related to patch failure should be considered when economic aspect is evaluated.…”

Multicenter Experience With 500 CardioCel Implants Used for the Repair of Congenital Heart Defects

“…A recently published study evaluated the cost effectiveness of CardioCel for repair of congenital heart defects in comparison with xenogenic, autologous, and synthetic patches over a 40-year period from the perspective of the data of the UK National Health Service. 17 According to the predictions in their model, the researchers observed that CardioCel was associated with reduced incidence of reoperations, increased qualityadjusted life-years, and cost savings in comparison with all other patches. The cost savings were greatest with the repair of atrioventricular septal defects.…”

“…The conclusion of this report was that CardioCel increases the health benefits and saves costs when used for surgery of congenital heart defects as an alternative to other patches. 17…”

Cost‐effectiveness of prenatal screening methods for congenital heart defects in pregnancies conceived by in‐vitro fertilization

“…The following supporting information may be found in the online version of this article: Table S1 Clinical utilities used in cost-effectiveness analysis of three screening strategies for congenital heart defects (CHD) in pregnancies conceived by in-vitro fertilization 19,22,[40][41][42][43][44][45][46][47][48][49]61,63…”