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Cost-Effectiveness of Left Ventricular Assist Devices in Ambulatory Patients With Advanced Heart Failure

Friday, January 13, 2017

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Jacqueline Baras Shreibati, Jeremy D. Goldhaber-Fiebert, Dipanjan Banerjee, Douglas K. Owens, Mark A. Hlatky

With the everpresent question of potentially extending LVAD therapy to ambulatory patients with advanced heart failure, the authors--using a Markov model--projected the incremental cost-efffectiveness ratio (ICER) of DT LVADs in this population as compared to conventional medical therapy.   The authors find that, although LVADs clearly extend quality-adjusted life-years (QALYs), the ICER is >$200K per QALY.  (Conventional cut-offs for ICER acceptability range from <$50K to <$100K.)  This ICER is thus cost-ineffective at present.   The study finds that this excessive cost is driven predominantly by follow-up care and readmissions, which suggests a potential target for improving ICER in the future.

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