Oleg Borisenko1, Gillian Wylie2, John Payne3, Staffan Bjessmo4, Jon Smith5, Richard Firmin6, Nizar Yonan7. 1. Synergus AB, Danderyd, Sweden oleg.borisenko@synergus.com. 2. Scottish Extracorporeal Life Support Service, Royal Hospital for Sick Children, Glasgow, UK. 3. Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Clydebank, UK. 4. Synergus AB, Danderyd, Sweden Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden. 5. Paediatric and Neonatal ECMO Service, Freeman Hospital, Newcastle upon Tyne, UK. 6. Glenfield General Hospital, Leicester, UK. 7. Department of Cardiothoracic Transplant, Wythenshawe Hospital, Manchester, UK.
Abstract
OBJECTIVES: The objective of the study was to assess the cost of using different blood pumps for short-term ventricular assist device (VAD) and extracorporeal life support (ECLS) systems for cardiac and cardiorespiratory failure in the UK. METHODS: The cost analysis presented was based on evaluation of the time required to provide circulatory support for the following indications: post-cardiac surgery cardiogenic shock, postacute myocardial infarction cardiogenic shock, deteriorating end-stage heart failure (ESHF) and the ability of different blood pumps to provide support for the necessary duration. The maximum length of support for each device was based on the manufacturers' recommendations. Direct medical cost of each treatment was evaluated only for the period of mechanical circulatory support in adults and children. Only the cost of device, placement and replacement procedures were considered. List prices were used for devices; resource use was based on expert opinion; unit costs were obtained from official UK sources and Wythenshawe hospital, Manchester, UK. Hospital perspective was utilized for analysis. Three VADs were selected for comparison in adults and two in children. Four centrifugal ECLS systems were selected for comparison in adults and two in children. RESULTS: In both VAD and ECLS indications, the CentriMag® was the least expensive when used for support of patients with end-stage heart failure. Compared with Cardiohelp® for ECLS (which has the same maximum claim duration of support of 30 days), CentriMag® lead to cost savings of £4294 per patient in all three clinical conditions considered. In post-cardiac surgery cardiogenic shock, CentriMag® VAD lead to savings of £5014 per patient compared with BPX-80. Results were robust in one-way sensitivity analysis in comparison with Cardiohelp®. CONCLUSIONS: CentriMag® and PediVAS® blood pumps can lead to significant cost savings to the National Health Service, when used instead of other pumps for short-term VAD or ECLS treatment.
OBJECTIVES: The objective of the study was to assess the cost of using different blood pumps for short-term ventricular assist device (VAD) and extracorporeal life support (ECLS) systems for cardiac and cardiorespiratory failure in the UK. METHODS: The cost analysis presented was based on evaluation of the time required to provide circulatory support for the following indications: post-cardiac surgery cardiogenic shock, postacute myocardial infarction cardiogenic shock, deteriorating end-stage heart failure (ESHF) and the ability of different blood pumps to provide support for the necessary duration. The maximum length of support for each device was based on the manufacturers' recommendations. Direct medical cost of each treatment was evaluated only for the period of mechanical circulatory support in adults and children. Only the cost of device, placement and replacement procedures were considered. List prices were used for devices; resource use was based on expert opinion; unit costs were obtained from official UK sources and Wythenshawe hospital, Manchester, UK. Hospital perspective was utilized for analysis. Three VADs were selected for comparison in adults and two in children. Four centrifugal ECLS systems were selected for comparison in adults and two in children. RESULTS: In both VAD and ECLS indications, the CentriMag® was the least expensive when used for support of patients with end-stage heart failure. Compared with Cardiohelp® for ECLS (which has the same maximum claim duration of support of 30 days), CentriMag® lead to cost savings of £4294 per patient in all three clinical conditions considered. In post-cardiac surgery cardiogenic shock, CentriMag® VAD lead to savings of £5014 per patient compared with BPX-80. Results were robust in one-way sensitivity analysis in comparison with Cardiohelp®. CONCLUSIONS: CentriMag® and PediVAS® blood pumps can lead to significant cost savings to the National Health Service, when used instead of other pumps for short-term VAD or ECLS treatment.
Authors: Faizan Amin; Julia Lombardi; Mosaad Alhussein; Juan Duero Posada; Adrian Suszko; Margaret Koo; Eddy Fan; Heather Ross; Vivek Rao; Ana Carolina Alba; Filio Billia Journal: CJC Open Date: 2020-09-16
Authors: Maziar Khorsandi; Mark Davidson; Omar Bouamra; Andrew McLean; Kenneth MacArthur; Ida Torrance; Gillian Wylie; Ed Peng; Mark Danton Journal: Ann Pediatr Cardiol Date: 2018 Jan-Apr