Cardiac resynchronization therapy (CRT) is cost-effective in mildly symptomatic heart failure (HF) patients, according to findings from an economic sub-study of the REVERSE (Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction) trial by Medtronic.
The REVERSE trial, sponsored by Medtronic, is a large-scale, global, randomized, double-blind trial that demonstrated the benefits of CRT in improving the function of the heart, including reduction in heart size and improvements in pumping efficiency, in certain asymptomatic or mild heart failure patients.
In this economic analysis of a subset of patients in the REVERSE trial, 262 European patients were randomized to receive CRT therapy or to have CRT therapy switched off for 24 months.
An economic model was developed to predict the effect of CRT on life years, quality-adjusted life years (QALYs) and costs over time periods up to 10 years.
The economic analysis was based on clinical data that showed at 24 months a worsening of heart failure in 34% of patients who did not have CRT therapy, compared with 19% of patients who did receive CRT therapy.
The results of this analysis showed a €14,278 per Quality Adjusted Life Years (QALY) gained for CRT, compared to the commonly used European willingness to pay (WTP) threshold of €33,000 per QALY gained.
The analysis also showed patients receiving CRT are estimated to gain almost one full life year (0.94) or 0.80 QALYs compared to the group not receiving CRT, at an additional cost of €11,455, over a 10 year time horizon.
Medtronic senior vice president and president of the Cardiac Rhythm Disease Management business Pat Mackin said the valuable data uncovered by the REVERSE trial should move us closer to expanding the use of CRT, and our hope is that earlier intervention with this treatment will allow physicians to provide better and more cost-effective patient care to combat this serious and often debilitating condition.