Cost-effectiveness analysis of the orbital atherectomy system

Two-year follow-up

Louis P. Garrison, Marita R. Zimmermann, Christopher H. Young, Janna Crittendon, Philippe Genereux

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background The presence of coronary artery calcification is associated with a significant burden of coronary artery disease along with being a predictor of increased adverse ischemic events. The Diamondback 360® Coronary Orbital Atherectomy System (OAS) is a novel device designed to facilitate treatment of calcified lesions. This study aimed to evaluate the cost-effectiveness of OAS compared to standard treatment. Methods A decision tree model utilizing ORBIT II clinical trial and Medicare data from the health system perspective was constructed. Target population was U.S. patients age ≥ 65 with coronary atherosclerosis due to a calcified coronary lesion, both inpatients and outpatients, and combined over a time horizon of two years for costs and lifetime for mortality. OAS was compared to standard treatment (use of balloon angioplasty to prepare stent-placement site). Outcomes were costs of index event and target vessel revascularization in two years, life–years gained, and incremental cost-effectiveness ratios (ICERs). Results On average, OAS was projected to cost 1702 less than standard treatment for inpatients, 2360 more than standard treatment for outpatients, and 959 more than standard treatment overall; the projected mortality reduction implies 0.41 life–years gained. Compared to standard treatment, OAS was dominant in an inpatient setting, had an ICER of 5759 per QALY in the outpatient setting, and had an ICER of 2340 per QALY overall. These ICERs are below the accepted threshold for highly cost-effective interventions of 50,000 per QALY. Conclusions Compared to standard treatment, OAS is likely to be cost-effective and was projected to be cost-saving in an inpatient setting. Summary A decision tree from the health system perspective was used to evaluate the cost-effectiveness of Diamondback 360® Coronary Orbital Atherectomy System (OAS), a novel device designed to facilitate treatment of calcified lesions. OAS was projected to cost 1702 less than standard treatment for inpatients, 2360 more than standard treatment for outpatients, and 959 more than standard treatment overall; the projected mortality reduction implies 0.41 life–years gained. Compared to standard treatment, OAS was dominant in an inpatient setting, had an ICER of 5759 per QALY in the outpatient setting, and overall had an ICER of 2340 per QALY.

Original languageEnglish (US)
Pages (from-to)86-90
Number of pages5
JournalCardiovascular Revascularization Medicine
Volume18
Issue number2
DOIs
StatePublished - Mar 1 2017
Externally publishedYes

Fingerprint

Atherectomy
Cost-Benefit Analysis
Quality-Adjusted Life Years
Inpatients
Costs and Cost Analysis
Outpatients
Therapeutics
Coronary Atherectomy
Decision Trees
Mortality
Coronary Artery Disease
Equipment and Supplies
Balloon Angioplasty
Health Services Needs and Demand
Health
Medicare
Information Systems

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Garrison, Louis P. ; Zimmermann, Marita R. ; Young, Christopher H. ; Crittendon, Janna ; Genereux, Philippe. / Cost-effectiveness analysis of the orbital atherectomy system : Two-year follow-up. In: Cardiovascular Revascularization Medicine. 2017 ; Vol. 18, No. 2. pp. 86-90.
@article{26c468b9fa2d4b5eb9636de244cb6f84,
title = "Cost-effectiveness analysis of the orbital atherectomy system: Two-year follow-up",
abstract = "Background The presence of coronary artery calcification is associated with a significant burden of coronary artery disease along with being a predictor of increased adverse ischemic events. The Diamondback 360{\circledR} Coronary Orbital Atherectomy System (OAS) is a novel device designed to facilitate treatment of calcified lesions. This study aimed to evaluate the cost-effectiveness of OAS compared to standard treatment. Methods A decision tree model utilizing ORBIT II clinical trial and Medicare data from the health system perspective was constructed. Target population was U.S. patients age ≥ 65 with coronary atherosclerosis due to a calcified coronary lesion, both inpatients and outpatients, and combined over a time horizon of two years for costs and lifetime for mortality. OAS was compared to standard treatment (use of balloon angioplasty to prepare stent-placement site). Outcomes were costs of index event and target vessel revascularization in two years, life–years gained, and incremental cost-effectiveness ratios (ICERs). Results On average, OAS was projected to cost 1702 less than standard treatment for inpatients, 2360 more than standard treatment for outpatients, and 959 more than standard treatment overall; the projected mortality reduction implies 0.41 life–years gained. Compared to standard treatment, OAS was dominant in an inpatient setting, had an ICER of 5759 per QALY in the outpatient setting, and had an ICER of 2340 per QALY overall. These ICERs are below the accepted threshold for highly cost-effective interventions of 50,000 per QALY. Conclusions Compared to standard treatment, OAS is likely to be cost-effective and was projected to be cost-saving in an inpatient setting. Summary A decision tree from the health system perspective was used to evaluate the cost-effectiveness of Diamondback 360{\circledR} Coronary Orbital Atherectomy System (OAS), a novel device designed to facilitate treatment of calcified lesions. OAS was projected to cost 1702 less than standard treatment for inpatients, 2360 more than standard treatment for outpatients, and 959 more than standard treatment overall; the projected mortality reduction implies 0.41 life–years gained. Compared to standard treatment, OAS was dominant in an inpatient setting, had an ICER of 5759 per QALY in the outpatient setting, and overall had an ICER of 2340 per QALY.",
author = "Garrison, {Louis P.} and Zimmermann, {Marita R.} and Young, {Christopher H.} and Janna Crittendon and Philippe Genereux",
year = "2017",
month = "3",
day = "1",
doi = "10.1016/j.carrev.2016.12.005",
language = "English (US)",
volume = "18",
pages = "86--90",
journal = "Cardiovascular Revascularization Medicine",
issn = "1553-8389",
publisher = "Elsevier Inc.",
number = "2",

}

Cost-effectiveness analysis of the orbital atherectomy system : Two-year follow-up. / Garrison, Louis P.; Zimmermann, Marita R.; Young, Christopher H.; Crittendon, Janna; Genereux, Philippe.

In: Cardiovascular Revascularization Medicine, Vol. 18, No. 2, 01.03.2017, p. 86-90.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Cost-effectiveness analysis of the orbital atherectomy system

T2 - Two-year follow-up

AU - Garrison, Louis P.

AU - Zimmermann, Marita R.

AU - Young, Christopher H.

AU - Crittendon, Janna

AU - Genereux, Philippe

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Background The presence of coronary artery calcification is associated with a significant burden of coronary artery disease along with being a predictor of increased adverse ischemic events. The Diamondback 360® Coronary Orbital Atherectomy System (OAS) is a novel device designed to facilitate treatment of calcified lesions. This study aimed to evaluate the cost-effectiveness of OAS compared to standard treatment. Methods A decision tree model utilizing ORBIT II clinical trial and Medicare data from the health system perspective was constructed. Target population was U.S. patients age ≥ 65 with coronary atherosclerosis due to a calcified coronary lesion, both inpatients and outpatients, and combined over a time horizon of two years for costs and lifetime for mortality. OAS was compared to standard treatment (use of balloon angioplasty to prepare stent-placement site). Outcomes were costs of index event and target vessel revascularization in two years, life–years gained, and incremental cost-effectiveness ratios (ICERs). Results On average, OAS was projected to cost 1702 less than standard treatment for inpatients, 2360 more than standard treatment for outpatients, and 959 more than standard treatment overall; the projected mortality reduction implies 0.41 life–years gained. Compared to standard treatment, OAS was dominant in an inpatient setting, had an ICER of 5759 per QALY in the outpatient setting, and had an ICER of 2340 per QALY overall. These ICERs are below the accepted threshold for highly cost-effective interventions of 50,000 per QALY. Conclusions Compared to standard treatment, OAS is likely to be cost-effective and was projected to be cost-saving in an inpatient setting. Summary A decision tree from the health system perspective was used to evaluate the cost-effectiveness of Diamondback 360® Coronary Orbital Atherectomy System (OAS), a novel device designed to facilitate treatment of calcified lesions. OAS was projected to cost 1702 less than standard treatment for inpatients, 2360 more than standard treatment for outpatients, and 959 more than standard treatment overall; the projected mortality reduction implies 0.41 life–years gained. Compared to standard treatment, OAS was dominant in an inpatient setting, had an ICER of 5759 per QALY in the outpatient setting, and overall had an ICER of 2340 per QALY.

AB - Background The presence of coronary artery calcification is associated with a significant burden of coronary artery disease along with being a predictor of increased adverse ischemic events. The Diamondback 360® Coronary Orbital Atherectomy System (OAS) is a novel device designed to facilitate treatment of calcified lesions. This study aimed to evaluate the cost-effectiveness of OAS compared to standard treatment. Methods A decision tree model utilizing ORBIT II clinical trial and Medicare data from the health system perspective was constructed. Target population was U.S. patients age ≥ 65 with coronary atherosclerosis due to a calcified coronary lesion, both inpatients and outpatients, and combined over a time horizon of two years for costs and lifetime for mortality. OAS was compared to standard treatment (use of balloon angioplasty to prepare stent-placement site). Outcomes were costs of index event and target vessel revascularization in two years, life–years gained, and incremental cost-effectiveness ratios (ICERs). Results On average, OAS was projected to cost 1702 less than standard treatment for inpatients, 2360 more than standard treatment for outpatients, and 959 more than standard treatment overall; the projected mortality reduction implies 0.41 life–years gained. Compared to standard treatment, OAS was dominant in an inpatient setting, had an ICER of 5759 per QALY in the outpatient setting, and had an ICER of 2340 per QALY overall. These ICERs are below the accepted threshold for highly cost-effective interventions of 50,000 per QALY. Conclusions Compared to standard treatment, OAS is likely to be cost-effective and was projected to be cost-saving in an inpatient setting. Summary A decision tree from the health system perspective was used to evaluate the cost-effectiveness of Diamondback 360® Coronary Orbital Atherectomy System (OAS), a novel device designed to facilitate treatment of calcified lesions. OAS was projected to cost 1702 less than standard treatment for inpatients, 2360 more than standard treatment for outpatients, and 959 more than standard treatment overall; the projected mortality reduction implies 0.41 life–years gained. Compared to standard treatment, OAS was dominant in an inpatient setting, had an ICER of 5759 per QALY in the outpatient setting, and overall had an ICER of 2340 per QALY.

UR - http://www.scopus.com/inward/record.url?scp=85010809675&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85010809675&partnerID=8YFLogxK

U2 - 10.1016/j.carrev.2016.12.005

DO - 10.1016/j.carrev.2016.12.005

M3 - Article

VL - 18

SP - 86

EP - 90

JO - Cardiovascular Revascularization Medicine

JF - Cardiovascular Revascularization Medicine

SN - 1553-8389

IS - 2

ER -