PMID- 31464176
OWN - NLM
STAT- MEDLINE
DCOM- 20200220
LR  - 20200220
IS  - 1941-837X (Electronic)
IS  - 1369-6998 (Linking)
VI  - 22
IP  - 10
DP  - 2019 Oct
TI  - Economic value and cost-effectiveness of biventricular versus right ventricular 
      pacing: results from the BLOCK-HF study.
PG  - 1088-1095
LID - 10.1080/13696998.2019.1652184 [doi]
AB  - Aims: The Biventricular vs Right Ventricular Pacing in Heart Failure Patients 
      with Atrioventricular Block (BLOCK-HF) demonstrated that biventricular (BiV) 
      pacing resulted in better clinical and structural outcomes compared to right 
      ventricular (RV) pacing in patients with atrioventricular (AV) block and reduced 
      left ventricular ejection fraction (LVEF; </=50%). This study investigated the 
      cost-effectiveness of BiV vs RV pacing in the patient population enrolled in the 
      BLOCK-HF trial. Methods: All-cause mortality, New York Heart Association (NYHA) 
      Class distribution over time, and NYHA-specific heart failure (HF)-related 
      healthcare utilization rates were predicted using statistical models based on 
      BLOCK-HF patient data. A proportion-in-state model calculated cost-effectiveness 
      from the Medicare payer perspective. Results: The predicted patient survival was 
      6.78 years with RV and 7.52 years with BiV pacing, a 10.9% increase over 
      lifetime. BiV pacing resulted in 0.41 more quality-adjusted life years (QALYs) 
      compared to RV pacing, at an additional cost of $12,537. The "base-case" 
      incremental cost-effectiveness ratio (ICER) was $30,860/QALY gained. Within the 
      clinical sub-groups, the highest observed ICER was $43,687 (NYHA Class I). 
      Patients receiving combined BiV pacing and defibrillation (BiV-D) devices were 
      projected to benefit more (0.84 years gained) than BiV pacemaker (BiV-P) 
      recipients (0.49 years gained), compared to dual-chamber pacemakers. Conclusions: 
      BiV pacing in AV block patients improves survival and attenuates HF progression 
      compared to RV pacing. ICERs were consistently below the US acceptability 
      threshold ($50,000/QALY). From a US Medicare perspective, the additional up-front 
      cost associated with offering BiV pacing to the BLOCK-HF patient population 
      appears justified.
FAU - Chung, Eugene S
AU  - Chung ES
AD  - The Carl and Edyth Lindner Research Center, The Christ Hospital Heart and 
      Vascular Center , Cincinnati , OH , USA.
FAU - St John Sutton, Martin G
AU  - St John Sutton MG
AD  - Cardiovascular Medicine Division, Hospital of the University of Pennsylvania , 
      Philadelphia , PA , USA.
FAU - Mealing, Stuart
AU  - Mealing S
AD  - Health Economics, ICON/Oxford Outcomes , Oxford , UK.
FAU - Sidhu, Manpreet K
AU  - Sidhu MK
AD  - Health Economics, ICON/Oxford Outcomes , New York , NY , USA.
FAU - Padhiar, Amie
AU  - Padhiar A
AD  - Health Economics, ICON/Oxford Outcomes , Oxford , UK.
FAU - Tsintzos, Stelios I
AU  - Tsintzos SI
AD  - Health Economics and Outcome Research, Cardiac Rhythm and Heart Failure (CRHF), 
      Medtronic International Trading Sarl , Tolochenaz , Switzerland.
FAU - Lu, Xiaoxiao
AU  - Lu X
AD  - Health Economics and Outcome Research, Cardiac Rhythm and Heart Failure (CRHF), 
      Medtronic Plc, Global Cardiac Rhythm Management Headquarters , Mounds View , MN , 
      USA.
FAU - Verhees, Koen J P
AU  - Verhees KJP
AD  - Clinical Evidence, Cardiac Rhythm and Heart Failure (CRHF), Medtronic Plc, Bakken 
      Research Center (BRC) , Maastricht , The Netherlands.
FAU - Lautenbach, Amy A
AU  - Lautenbach AA
AD  - Health Economics and Outcome Research, Cardiac Rhythm and Heart Failure (CRHF), 
      Medtronic Plc, Global Cardiac Rhythm Management Headquarters , Mounds View , MN , 
      USA.
FAU - Curtis, Anne B
AU  - Curtis AB
AD  - Buffalo General Medical Center, University at Buffalo , Buffalo , NY , USA.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
DEP - 20190829
PL  - England
TA  - J Med Econ
JT  - Journal of medical economics
JID - 9892255
SB  - IM
MH  - Atrioventricular Block/surgery
MH  - Cardiac Resynchronization Therapy/*economics
MH  - *Cost-Benefit Analysis
MH  - Double-Blind Method
MH  - Female
MH  - Health Policy
MH  - Heart Failure/*surgery
MH  - Heart Ventricles/physiopathology/surgery
MH  - Humans
MH  - Male
MH  - New York
MH  - Pacemaker, Artificial
MH  - Patient Acceptance of Health Care
MH  - Quality of Life
MH  - Quality-Adjusted Life Years
MH  - Ventricular Function
OTO - NOTNLM
OT  - C10
OT  - C50
OT  - Cardiac resynchronization therapy
OT  - cost-effectiveness
OT  - health economics
OT  - health policy
OT  - heart failure
EDAT- 2019/08/30 06:00
MHDA- 2020/02/23 06:00
CRDT- 2019/08/30 06:00
PHST- 2019/08/30 06:00 [pubmed]
PHST- 2020/02/23 06:00 [medline]
PHST- 2019/08/30 06:00 [entrez]
AID - 10.1080/13696998.2019.1652184 [doi]
PST - ppublish
SO  - J Med Econ. 2019 Oct;22(10):1088-1095. doi: 10.1080/13696998.2019.1652184. Epub 
      2019 Aug 29.