Improving the quality of percutaneous revascularisation in patients with multivessel disease in Australia: cost- effectiveness, public health implications, and budget impact of FFR-guided PCI

Uwe Siebert, Marjan Arvandi, Raffaella M. Gothe, Bernhard Bornschein, David Eccleston, Darren L. Walters, James Rankin, Bernard de Bruyne, William F. Fearon, Nico H. Pijls, Richard Harper

Research output: Contribution to journalArticleAcademicpeer-review

21 Citations (Scopus)

Abstract

Purpose: The international multicentre FAME Study (n=1,005) demonstrated significant health benefits for patients undergoing multivessel percutaneous coronary intervention (PCI) guided by fractional flow reserve (FFR) measurement compared with angiography guidance alone (ANGIO). We determined the cost-effectiveness and the public health/budget impact for Australia. Methods: We performed a prospective economic evaluation comparing FFR vs. ANGIO in patients with multivessel disease based on original patient-level FAME data. We used Australian utilities (EQ-5D) and costs to calculate quality-adjusted life years (QALYs) and incremental cost-effectiveness adopting the societal perspective. The public health and budget impact from the payer's perspective was based on Australian PCI registries. Uncertainty was explored using deterministic sensitivity analyses and the bootstrap method (n=5,000 samples). Results: The cost-effectiveness analysis showed that FFR was cost-saving and reduces costs by 1,776 AUD per patient during one year. Over a two-year time horizon, the public health impact ranged from 7.8 to 73.9 QALYs gained and the budget impact from 1.8 to 14.5 million AUD total cost savings. Sensitivity analyses demonstrated that FFR was cost-saving over a wide range of assumptions. Conclusions: FFR-guided PCI in patients with multivessel coronary disease substantially reduces cardiac events, improves QALYs and is cost-saving in the Australian health care system.

Original languageEnglish
Pages (from-to)527-533
Number of pages7
JournalHeart, Lung and Circulation
Volume23
Issue number6
DOIs
Publication statusPublished - 1 Jan 2014

Keywords

  • Coronary artery disease
  • Cost-benefit analysis
  • Flow reserve
  • Multivessel disease
  • Percutaneous coronary intervention (PCI)

Fingerprint Dive into the research topics of 'Improving the quality of percutaneous revascularisation in patients with multivessel disease in Australia: cost- effectiveness, public health implications, and budget impact of FFR-guided PCI'. Together they form a unique fingerprint.

Cite this