Economic Evaluation seminar - Early Cost Effectiveness Analysis of a Polymeric Heart Valve
Event details
Abstract:
Background: A novel polymeric heart valve for aortic position made from styrene-block-ethylene/butylene-block-styrene copolymers (PV-SEBS) is in development which promises to reduce acute events and reinterventions by mitigating valve-related events (VREs); structural valve deterioration (SVD), thrombosis, and endocarditis, and last a lifetime without requiring lifetime anticoagulation medication. Decisions about investment in Research and Development (R&D) activities and pricing could be optimised by considering that funding and uptake of new technologies by health systems depends on clinical and economic value to patients and health systems and on uncertainty over this value.
Objective: Examine alternative R&D activities, consider pricing strategies, and assess the potential cost-effectiveness of the novel polymeric heart valve in the UK health system.
Methodology: We evaluate the clinical and economic value of the novel PV-SEBS in comparison to bioprosthetic heart valves in the UK by developing a de novo early economic model. The model adapts the NICE NG208 economic model to allow explicit comparison of biological and the novel PV-SEBS in surgical aortic valve replacement. The relative treatment effect on the rates of VREs for polymeric valves were derived via structural elicitation from clinical experts. Probabilistic, sensitivity, and value of information analyses were conducted to determine key cost-effectiveness drivers, incorporate uncertainty, and examine the value of further research.
Results: The economic model shows that effects on SVD, of all VREs, have the largest impact on required re-interventions and leads to the highest value-based price (VBP), that is, the price of the polymeric valve where it would remain cost effective given its treatment effect. A relative risk of 0.75 on SVD alone leads to a reduction of 17 re-interventions per 1000 patients, and a VBP of £5244. Effects on thrombosis had the smallest impact, with a relative risk effect of 0.75 on thrombosis reducing re-interventions per 1000 patients by only 1 and allowing a VBP of £4765.
Conclusion: Early identification of required evidence and prioritization of points for development (in this case evidence and development focus on the PV-SEBS resistance to SVD) can significantly impact clinical and economic value.
Authors: Layne R, Ascione R, Moggridge G, Serrani M, Stasiak J, Soares MO
If you are not a member of University of York staff and are interested in attending a seminar, please contact alfredo.palacios
About the speaker
Rojé Layne, Research Fellow, Centre for Health Economics
Contact
Alfredo Palacios / Shainur Premji