PMID- 26894467
OWN - NLM
STAT- MEDLINE
DCOM- 20161213
LR  - 20201216
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 209
DP  - 2016 Apr 15
TI  - Real-world cost effectiveness of MitraClip combined with Medical Therapy Versus 
      Medical therapy alone in patients with moderate or severe mitral regurgitation.
PG  - 153-60
LID - S0167-5273(16)30211-X [pii]
LID - 10.1016/j.ijcard.2016.01.212 [doi]
AB  - BACKGROUND: We evaluated the real-world cost-effectiveness of the MitraClip 
      system (Abbott Vascular Inc., Menlo Park, CA) plus medical therapy for patients 
      with moderate/severe mitral regurgitation, as compared with medical therapy (MT) 
      alone. METHODS: Clinical records of patients with moderate to severe functional 
      mitral regurgitation treated with MitraClip (N=232) or with MT (N=151) were 
      collected and outcome analyzed with propensity score adjustment to reduce 
      selection bias. Twelve-month outcomes were modeled over a lifetime horizon to 
      conduct a cost-effectiveness analysis, in the payer's perspective. Costs and 
      benefits were discounted at an annual rate of 3.5%. RESULTS: After propensity 
      score adjustment, the average treatment effect was -9.5% probability of dying at 
      12months and, following lifetime modeling, 3.35+/-0.75 incremental life years and 
      3.01+/-0.57 incremental quality-adjusted life years. MitraClip contributed to a 
      higher decrease in re-hospitalizations at 12months (difference=-0.54+/-0.08) and 
      generated a more likely improvement in the New York Heart Association (NYHA) 
      class at 12months versus NYHA at enrollment. Incremental costs, adapted to five 
      possible scenarios, ranged from 14,493 to 29,795 euro contributing to an incremental 
      cost-effectiveness ratio ranging from 4796 to 7908 euro. CONCLUSIONS: Compared to MT 
      alone and given conventional threshold values, MitraClip can be considered a 
      cost-effective procedure. The cost-effectiveness of MitraClip is in line or 
      superior to the one of other non-pharmaceutical strategies for heart failure.
CI  - Copyright (c) 2016 Elsevier Ireland Ltd. All rights reserved.
FAU - Armeni, Patrizio
AU  - Armeni P
AD  - CERGAS (Centre for Research on Social and Healthcare Management) Bocconi 
      University, Milan, Italy.
FAU - Boscolo, Paola R
AU  - Boscolo PR
AD  - CERGAS (Centre for Research on Social and Healthcare Management) Bocconi 
      University, Milan, Italy.
FAU - Tarricone, Rosanna
AU  - Tarricone R
AD  - CERGAS (Centre for Research on Social and Healthcare Management) Bocconi 
      University, Milan, Italy; Department of Policy Analysis and Public Management, 
      Bocconi University, Milan, Italy.
FAU - Capodanno, Davide
AU  - Capodanno D
AD  - Ferrarotto Hospital, University of Catania, Catania, Italy. Electronic address: 
      dcapodanno@gmail.com.
FAU - Maggioni, Aldo P
AU  - Maggioni AP
AD  - ANMCO Research Centre, Firenze, Italy.
FAU - Grasso, Carmelo
AU  - Grasso C
AD  - Ferrarotto Hospital, University of Catania, Catania, Italy.
FAU - Tamburino, Corrado
AU  - Tamburino C
AD  - Ferrarotto Hospital, University of Catania, Catania, Italy.
FAU - Maisano, Francesco
AU  - Maisano F
AD  - Cardiovascular Surgery Department, University Hospital of Zurich, Switzerland.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20160202
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
RN  - 0 (Cardiotonic Agents)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiotonic Agents/*economics/therapeutic use
MH  - Cohort Studies
MH  - *Cost-Benefit Analysis
MH  - Female
MH  - Heart Failure/economics/mortality/therapy
MH  - Heart Valve Prosthesis Implantation/*economics/mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Insufficiency/*economics/mortality/*therapy
MH  - Retrospective Studies
MH  - *Severity of Illness Index
MH  - Survival Rate/trends
EDAT- 2016/02/20 06:00
MHDA- 2016/12/15 06:00
CRDT- 2016/02/20 06:00
PHST- 2015/11/23 00:00 [received]
PHST- 2016/01/07 00:00 [revised]
PHST- 2016/01/31 00:00 [accepted]
PHST- 2016/02/20 06:00 [entrez]
PHST- 2016/02/20 06:00 [pubmed]
PHST- 2016/12/15 06:00 [medline]
AID - S0167-5273(16)30211-X [pii]
AID - 10.1016/j.ijcard.2016.01.212 [doi]
PST - ppublish
SO  - Int J Cardiol. 2016 Apr 15;209:153-60. doi: 10.1016/j.ijcard.2016.01.212. Epub 
      2016 Feb 2.