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 language | English (US) |
|---|---|
| Pages (from-to) | 86-90 |
| Number of pages | 5 |
| Journal | Cardiovascular Revascularization Medicine |
| Volume | 18 |
| Issue number | 2 |
| DOIs | |
| State | Published - Mar 1 2017 |
| Externally published | Yes |
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All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine
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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 journal › Article
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
C2 - 28017543
AN - SCOPUS:85010809675
VL - 18
SP - 86
EP - 90
JO - Cardiovascular Revascularization Medicine
JF - Cardiovascular Revascularization Medicine
SN - 1553-8389
IS - 2
ER -