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The cost impact of short-term ventricular assist devices and extracorporeal life support systems therapies on the National Health Service in the UK

Lookup NU author(s): Dr Jon Smith

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Abstract

OBJECTIVES: The objective of the study was to assess the cost of using different blood pumps for short-term ventricular assist device (VAD) and extracorporeal life support (ECLS) systems for cardiac and cardiorespiratory failure in the UK.METHODS: The cost analysis presented was based on evaluation of the time required to provide circulatory support for the following indications: post-cardiac surgery cardiogenic shock, postacute myocardial infarction cardiogenic shock, deteriorating end-stage heart failure (ESHF) and the ability of different blood pumps to provide support for the necessary duration. The maximum length of support for each device was based on the manufacturers' recommendations. Direct medical cost of each treatment was evaluated only for the period of mechanical circulatory support in adults and children. Only the cost of device, placement and replacement procedures were considered. List prices were used for devices; resource use was based on expert opinion; unit costs were obtained from official UK sources and Wythenshawe hospital, Manchester, UK. Hospital perspective was utilized for analysis. Three VADs were selected for comparison in adults and two in children. Four centrifugal ECLS systems were selected for comparison in adults and two in children.RESULTS: In both VAD and ECLS indications, the CentriMagA (R) was the least expensive when used for support of patients with end-stage heart failure. Compared with CardiohelpA (R) for ECLS (which has the same maximum claim duration of support of 30 days), CentriMagA (R) lead to cost savings of A 4294 pound per patient in all three clinical conditions considered. In post-cardiac surgery cardiogenic shock, CentriMagA (R) VAD lead to savings of A 5014 pound per patient compared with BPX-80. Results were robust in one-way sensitivity analysis in comparison with CardiohelpA (R).CONCLUSIONS: CentriMagA (R) and PediVASA (R) blood pumps can lead to significant cost savings to the National Health Service, when used instead of other pumps for short-term VAD or ECLS treatment.

Publication metadata

Author(s): Borisenko O, Wylie G, Payne J, Bjessmo S, Smith J, Firmin R, Yonan N

Publication type: Article

Publication status: Published

Journal: Interactive CardioVasc Thoracic Surgery

Year: 2014

Volume: 19

Issue: 1

Pages: 41-48

Print publication date: 01/07/2014

Online publication date: 25/03/2014

Acceptance date: 27/02/2014

ISSN (print): 1569-9293

ISSN (electronic): 1569-9285

Publisher: Oxford University Press

URL: http://dx.doi.org/10.1093/icvts/ivu078

DOI: 10.1093/icvts/ivu078

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