Cost-effectiveness of the MitraClip device in German heart failure patients with secondary mitral regurgitation

Bent Estler (), Volker Rudolph, Yana Seleznova, Arim Shukri, Stephanie Stock and Dirk Müller
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Bent Estler: University of Cologne
Volker Rudolph: University Hospital of the Ruhr University Bochum
Yana Seleznova: University of Cologne
Arim Shukri: University of Cologne
Stephanie Stock: University of Cologne
Dirk Müller: University of Cologne

The European Journal of Health Economics, 2023, vol. 24, issue 3, No 3, 349-358

Abstract: Abstract Aim To evaluate the cost-effectiveness of the MitraClip device (MitraClip) in addition to optimal medical therapy (OMT) in patients with heart failure and secondary mitral regurgitation in Germany. Methods and results A model-based economic evaluation was performed to estimate the incremental cost per quality-adjusted life-years (QALYs) for patients with a moderate-to-severe or severe secondary mitral regurgitation receiving MitraClip plus OMT compared with OMT alone from the statutory health insurance (SHI) perspective. Transition probabilities, data on survival rates, and hospitalization rates were obtained from the COAPT trial, a randomized-controlled multicenter trial. Data on health utility and costs were taken from published evidence. To assess parameter uncertainty, several deterministic and probabilistic sensitivity analyses were performed. The incremental costs per QALY gained were € 59,728 (costs/incremental life years gained: € 42,360). The results were most sensitive to the transition probabilities and the hospitalization rates. The probabilistic sensitivity analysis showed that the MitraClip strategy was cost-effective with a probability of 80% at a willingness-to-pay threshold of € 67,000/QALY. Conclusions Depending on the willingness-to-pay threshold, for patients with heart failure and a moderate-to-severe or severe secondary mitral regurgitation the MitraClip can be cost-effective from the perspective of the German SHI. Graphical abstract

Keywords: Heart failure; Secondary mitral regurgitation; Cost-effectiveness; Transcatheter-valve repair; MitraClip; Germany (search for similar items in EconPapers)
Date: 2023
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DOI: 10.1007/s10198-022-01476-4

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