TCT-575 Cost-Effectiveness Analysis of Percutaneous Ventricular Assist Devices vs Intra-Aortic Balloon Pump for High-Risk Percutaneous Coronary Intervention (HRPCI)

Document Type

Conference Proceeding

Publication Date

10-29-2024

Publication Title

J Am Coll Cardiol

Abstract

Background: Health care resource utilization and costs are important when considering Impella percutaneous ventricular assist device (PVAD) supported HRPCI. A prior cost-effectiveness comparison of PVAD vs intra-aortic balloon pump (IABP) for HRPCI from the 2012 PROTECT II trial estimated an incremental cost-effectiveness ratio of $39,389/quality-adjusted life year (QALY) for pVAD. Our study provides an up-to-date cost-effectiveness analysis. Methods: Patients undergoing PVAD vs IABP-supported HRPCI between 2018 and 2024 were identified from the Premier Healthcare Database (PHD) and propensity matched to balance baseline factors. Major adverse cardiovascular events (MACE) including myocardial infarction (MI), stroke, and death up to 2 years were collected. Costs reported in the PHD were used to estimate quality-adjusted life years (QALY) based on age and expected disutility from MI or stroke using previously published assumptions. Markov models were used to calculate incremental cost-effectiveness ratio (ICER) for PVAD vs IABP and evaluate the probability of cost-effectiveness based on willingness to pay thresholds. Results: The cost of index hospitalization was higher for PVAD compared with IABP; however, PVAD was associated with reduced rates of MACE and subsequent reductions in QALYs resulting in an ICER of $26,450/QALY (Figure 1). [Formula presented] Conclusion: The ICER for PVAD vs IABP-supported HRPCI appears to have decreased over the past decade to $26,450/QALY, and based on contemporary US thresholds, is considered cost-effective. Categories: CORONARY: Complex and Higher Risk Procedures for Indicated Patients (CHIP).

Volume

84

Issue

18

First Page

B210

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