OBJECTIVE

Cost-effectiveness analysis of HeartMate3 support system and optimal drug therapy in patients with severe chronic heart failure (CHF); to analyze potential impact of HeartMate3 implantation on healthcare budget in the Russian Federation.

MATERIAL AND METHODS

The target population included patients with CHF NYHA class III—IV and reduced left ventricular ejection fraction. Cost-effectiveness analysis of HeartMate3 device and ODT in target population was carried out in the Markov model with a modeling time horizon of 5, 6, 8, 12 and 15 years. We estimated the incremental cost-effectiveness ratio (ICER) per quality-adjusted life year for HeartMate3 and ODT. Budget impact analysis implied the costs of current and expected practice of treating CHF in target population from the healthcare system point of view. The current practice was ODT only, the expected practice — HeartMate3 (minimum, optimal and maximum scenarios with annual number of implantations from 70 to 700).

RESULTS

The (ICER) per quality-adjusted life year for HeartMate3 compared to ODT amounted to 6.2 million rubles in 5-year modeling horizon and 3.6 million rubles in 15-year horizon. HeartMate3 will lead increase healthcare costs over 5 years by 14 (+1.48%), 24 (+2.57%) or 40.6 billion rubles (+4.32%) for the minimum, optimal and maximum implantation implementation scenarios, respectively.

CONCLUSION

Cost-effectiveness of HeartMate3 increases as the simulation time horizon increases. Healthcare costs will increase only slightly even in maximum scenario of HeartMate3 implementation (700 implantations annually for 5 years).