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Gervacio, Giselle G.; Kimwell, Miharu J. M.; Fadreguilan, Erdie C.; De Guzman, Denese C.; Gabriel, E. A.; Tolentino, Clara S.; David, Gladys R. S.
Journal of arrhythmia, April 2023, Letnik: 39, Številka: 2Journal Article
Background Radiofrequency ablation (RFA) is the standard of care in the management of supraventricular tachycardia (SVT). Its cost‐effectiveness in an emerging Asian country has not been studied. Objectives A cost‐utility analysis of RFA versus optimal medical therapy (OMT) among Filipinos with SVT was conducted using the public healthcare provider's perspective. Methods A simulation cohort using a lifetime Markov model was constructed using patient interviews, a review of literature, and expert consensus. Three basic health states were defined: stable, SVT recurrence, and death. The incremental cost per quality‐adjusted life year (ICER) was determined for both arms. Utilities for the entry states were derived from patient interviews using the EQ5D‐5L tool; utilities for other health states were taken from publications. Costs were assessed from the healthcare payer perspective. A sensitivity analysis was done. Results Base case analysis showed that RFA versus OMT is both highly cost‐effective at 5 years and over a lifetime. RFA at 5 years costs about PhP276,913.58 (USD5,446) versus OMT of PhP151,550.95 (USD2,981) per patient. Discounted lifetime costs were PhP280,770.32 (USD5,522) for RFA, versus PhP259,549.74 (USD5,105) for OMT. There was improved quality of life with RFA (8.1 vs. 5.7 QALYs per patient). The 5‐year and lifetime incremental cost‐effectiveness ratios were PhP148,741.40 (USD2,926) and Php15,000 (USD295), respectively. Sensitivity analysis showed 56.7% of simulations for RFA fell below a GDP‐benchmarked willingness‐to‐pay (WTP) threshold. Conclusion Despite the initial higher cost, RFA versus OMT for SVT is highly cost‐effective from the Philippine public health payer's perspective. Radiofrequency ablation for Supraventricular tachycardia has been found to be highly cost‐effective, costing less than one GDP, based on a Markov model of patients from an emerging economy. This finding is robust across a wide range of inputs in the sensitivity analysis. This may be explained by the curative nature of the procedure.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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Vir: Osebne bibliografije
in: SICRIS
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