PMID- 35067868
OWN - NLM
STAT- MEDLINE
DCOM- 20220315
LR  - 20220507
IS  - 1865-8652 (Electronic)
IS  - 0741-238X (Print)
IS  - 0741-238X (Linking)
VI  - 39
IP  - 3
DP  - 2022 Mar
TI  - Budget Impact Analysis of Impella CP((R)) Utilization in the Management of 
      Cardiogenic Shock in France: A Health Economic Analysis.
PG  - 1293-1309
LID - 10.1007/s12325-022-02040-5 [doi]
AB  - INTRODUCTION: Early detection and treatment of cardiogenic shock (CS) is crucial 
      to avoid irreparable multiorgan damage and mortality. Impella CP((R)) is a novel 
      temporary mechanical circulatory support (MCS) device associated with greater 
      hemodynamic support and significantly fewer device-related complications compared 
      with other MCS devices, e.g., intra-aortic balloon pumps (IABP) and venoarterial 
      extracorporeal membrane oxygenation (VA-ECMO). The present study evaluated the 
      budget impact of introducing Impella CP versus IABP and VA-ECMO in patients with 
      CS following an acute myocardial infarction (MI) in France. METHODS: A budget 
      impact model was developed to compare the cost of introducing Impella CP with 
      continuing IABP and VA-ECMO treatment from a Mandatory Health Insurance (MHI) 
      perspective in France over a 5-year time horizon, with 700 patients with 
      refractory CS assumed to be eligible for treatment per year. Costs associated 
      with Impella CP and device-related complications for all interventions were 
      captured and clinical input data were based on published sources. Scenario 
      analyses were performed around key parameters. RESULTS: Introducing Impella CP 
      was associated with cumulative cost savings of EUR 2.7 million over 5 years, 
      versus continuing current clinical practice with IABP and VA-ECMO. Cost savings 
      were achieved in every year of the analysis and driven by the lower incidence of 
      device-related complications with Impella CP, with estimated 5-year cost savings 
      of EUR 22.4 million due to avoidance of complications. Total cost savings of more 
      than EUR 250,000 were projected in the first year of the analysis, which 
      increased as the market share of Impella CP was increased. Scenario analyses 
      indicated that the findings of the analysis were robust. CONCLUSION: Treatment 
      with Impella CP in adult patients aged less than 75 years in a state of 
      refractory CS following an MI was projected to lead to substantial cost savings 
      from an MHI perspective in France, compared with continuing current clinical 
      practice.
CI  - (c) 2022. The Author(s).
FAU - Delmas, Clement
AU  - Delmas C
AD  - Intensive Cardiac Care Unit, Cardiology Department, Rangueil University Hospital, 
      Toulouse, France.
FAU - Pernot, Mathieu
AU  - Pernot M
AD  - Department of Cardiology and Cardiovascular Surgery, Haut-Leveque University 
      Hospital, Bordeaux, France.
FAU - Le Guyader, Alexandre
AU  - Le Guyader A
AD  - Department of Thoracic and Cardiovascular Surgery, Dupuytren University Hospital, 
      Limoges, France.
FAU - Joret, Romain
AU  - Joret R
AD  - SGE Consulting, Paris, France. romain.joret@sge-consulting.org.
FAU - Roze, Stephane
AU  - Roze S
AD  - VYOO Agency, Lyon, France.
FAU - Lebreton, Guillaume
AU  - Lebreton G
AD  - Cardiac Surgery Department, Pitie-Salpetriere Hospital, Sorbonne University, 
      Paris, France.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220123
PL  - United States
TA  - Adv Ther
JT  - Advances in therapy
JID - 8611864
MH  - Aged
MH  - *Extracorporeal Membrane Oxygenation/adverse effects
MH  - France
MH  - *Heart-Assist Devices/adverse effects
MH  - Humans
MH  - *Myocardial Infarction/complications/therapy
MH  - Shock, Cardiogenic/etiology/therapy
PMC - PMC8918169
OTO - NOTNLM
OT  - Budget impact
OT  - Cardiogenic shock
OT  - France
OT  - Impella CP(R)
OT  - Left-ventricular assist devices
EDAT- 2022/01/25 06:00
MHDA- 2022/03/16 06:00
PMCR- 2022/01/23
CRDT- 2022/01/24 05:49
PHST- 2021/09/03 00:00 [received]
PHST- 2022/01/05 00:00 [accepted]
PHST- 2022/01/25 06:00 [pubmed]
PHST- 2022/03/16 06:00 [medline]
PHST- 2022/01/24 05:49 [entrez]
PHST- 2022/01/23 00:00 [pmc-release]
AID - 10.1007/s12325-022-02040-5 [pii]
AID - 2040 [pii]
AID - 10.1007/s12325-022-02040-5 [doi]
PST - ppublish
SO  - Adv Ther. 2022 Mar;39(3):1293-1309. doi: 10.1007/s12325-022-02040-5. Epub 2022 
      Jan 23.