Utility Estimates for Decision–Analytic Modeling in Chronic Heart Failure—Health States Based on New York Heart Association Classes and Number of Rehospitalizations

Göhler, Alexander; Geisler, Benjamin P.; Manne, Jennifer; Kosiborod, Mikhail; Zhang, Zefeng; Weintraub, William S.; Spertus, John A.; Gazelle, G. Scott; Siebert, Uwe; Cohen, David J.

doi:10.1111/j.1524-4733.2008.00425.x

Cited by 105 publications

(90 citation statements)

References 11 publications

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“…Interestingly, all the available CE studies rely on the same UK studies for utility data. Actually, EuroQol five dimensions questionnaire utility scores for LVAD patients were derived from the NYHA Functional Classification using the relationship between EuroQol five dimensions questionnaire and NYHA for HF patients, as described elsewhere 33. Because there are uncertainties around the utility values, we performed one‐way sensitivity analysis using the assumptions derived from our single‐centre cohort to test robustness of the model; the sensitivity results showed that our estimates of the ICERs were reasonably robust to changes in the utility assumptions.…”

Section: Discussionmentioning

confidence: 99%

Cost‐effectiveness of left ventricular assist devices for patients with end‐stage heart failure: analysis of the French hospital discharge database

Tadmouri¹,

Blomkvist²,

Landais³

et al. 2017

ESC Heart Failure

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AimsAlthough left ventricular assist devices (LVADs) are currently approved for coverage and reimbursement in France, no French cost‐effectiveness (CE) data are available to support this decision. This study aimed at estimating the CE of LVAD compared with medical management in the French health system.Methods and resultsIndividual patient data from the ‘French hospital discharge database’ (Medicalization of information systems program) were analysed using Kaplan–Meier method. Outcomes were time to death, time to heart transplantation (HTx), and time to death after HTx. A micro‐costing method was used to calculate the monthly costs extracted from the Program for the Medicalization of Information Systems. A multistate Markov monthly cycle model was developed to assess CE. The analysis over a lifetime horizon was performed from the perspective of the French healthcare payer; discount rates were 4%. Probabilistic and deterministic sensitivity analyses were performed. Outcomes were quality‐adjusted life years (QALYs) and incremental CE ratio (ICER). Mean QALY for an LVAD patient was 1.5 at a lifetime cost of €190 739, delivering a probabilistic ICER of €125 580/QALY [95% confidence interval: 105 587 to 150 314]. The sensitivity analysis showed that the ICER was mainly sensitive to two factors: (i) the high acquisition cost of the device and (ii) the device performance in terms of patient survival.ConclusionsOur economic evaluation showed that the use of LVAD in patients with end‐stage heart failure yields greater benefit in terms of survival than medical management at an extra lifetime cost exceeding the €100 000/QALY. Technological advances and device costs reduction shall hence lead to an improvement in overall CE.

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Section: Discussionmentioning

confidence: 99%

Cost‐effectiveness of left ventricular assist devices for patients with end‐stage heart failure: analysis of the French hospital discharge database

Tadmouri¹,

Blomkvist²,

Landais³

et al. 2017

ESC Heart Failure

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“…By Ghana's threshold based on threefold of the GDP per capita (US$5,121), Entresto TM remained not cost-effective when both the best case and worst case utility values are assumed. Thus, the cost-effectiveness of Entresto TM was not sensitive to the plausible range of utilities reported in the literature [2,19]. However, a threshold analysis shows that Entresto TM could only become cost-effective in the Ghanaian context when it is sold at US$101.96 (GH¢438.43) or lower for a one-month pack.…”

Section: Sensitivity Analysismentioning

confidence: 95%

“…Estimation of the model parameters was based largely on findings reported from a pivotal trial, PARADIGM-HF trial [9,10] and previous economic evaluations involving CHF patients [2,18,19]. A cohort of 42 years old was used to reflect the reported mean age at diagnosis for CHF patients in Ghana [5].…”

Section: Overviewmentioning

confidence: 99%

The Cost-Effectiveness of Entresto™ (Sacubitril and Valsartan) Compared with Enalapril in Managing Chronic Heart Failure in Ghana: Decision Analytic Modelling

Asamani¹

2017

Health Econ Outcome Res

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“…Ideally, utility data are required to differentiate between the health status of patients in the different states of the Markov model using a generic measure of health such as the EQ-5D. 152 A recent study by Gohler et al 153 addresses the limitations of currently available data with respect to providing utility estimates that can be linked to common proxy health states in HF. The study uses primary data from EPHESUS to estimate utility values for patients with HF according to NYHA classification and number of CV rehospitalisations.…”

Section: Quality Of Lifementioning

confidence: 99%

A systematic review and economic evaluation of the clinical effectiveness and cost-effectiveness of aldosterone antagonists for postmyocardial infarction heart failure

McKenna

Burch²,

Suekarran³

et al. 2010

Health Technol Assess

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Utility Estimates for Decision–Analytic Modeling in Chronic Heart Failure—Health States Based on New York Heart Association Classes and Number of Rehospitalizations

Abstract: NYHA class and number of cardiovascular rehospitalizations are established proxies for CHF progression and can be linked to utilities when used as health states in a Markov model. NYHA class should be used when feasible.

Cited by 105 publications

References 11 publications

Cost‐effectiveness of left ventricular assist devices for patients with end‐stage heart failure: analysis of the French hospital discharge database

Cost‐effectiveness of left ventricular assist devices for patients with end‐stage heart failure: analysis of the French hospital discharge database

The Cost-Effectiveness of Entresto™ (Sacubitril and Valsartan) Compared with Enalapril in Managing Chronic Heart Failure in Ghana: Decision Analytic Modelling

A systematic review and economic evaluation of the clinical effectiveness and cost-effectiveness of aldosterone antagonists for postmyocardial infarction heart failure

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