Cost Effectiveness of Renal Denervation Therapy fo

Authors: Daniel Gladwell Thea Henry Mark Cook Ron Akehurst

Publish Date: 2014/08/03

Volume: 12, Issue: 6, Pages: 611-622

PDF Link

Abstract

A patient lifetime economic Markov heathstate model was developed linking expected changes in SBP to reductions in risks for cardiovascular events and renal complications using the Framingham PROCAM and other published risk equations The model was developed from the perspective of the healthcare payer in the UK using relevant cost data from 2012 Clinical effectiveness for RDN a mean reduction of 32 mmHg in SBP was taken from the phase III Symplicity HTN2 trial in patients with a mean baseline SBP of 178 mmHg HTN2 was the largest multicenter randomized controlled trial on the effectiveness of RDN therapy at the time of the model development A systematic review identified UKspecific sources for utility mortality and cost parameter values and included recently published UK guidelines for the clinical management of hypertensionRDN therapy resulted in an increase in health benefit over a patient’s lifetime compared with antihypertensive pharmacological treatment alone 1277 vs 1216 QALYs discounted Additional lifetime costs per patient were modeled at £2961 equivalent to an incremental cost per additional QALY of £4805 This result was robust to full probabilistic sensitivity and scenario analysesDG TH and RA are employees of BresMed Health Solutions which was reimbursed by Medtronic Ltd as a consultancy for developing the UK RDN model and preparing the manuscript They have no other competing interests in this study MC is an employee of Medtronic LtdDG guarantor and TH led the model design and construction and developed the costeffectiveness analyses RA provided conceptual design for the model and coauthored the manuscript MC coauthored the manuscript and provided the clinical input and direction for the modeling All authors have read and agreed to the content of this publication

Keywords: