Health care cost analysis of enhanced pacing modalities in bradycardia patients: Portuguese case study on the results of the MINERVA trial
Introduction: The MINERVA trial established that atrial preventive pacing and atrial antitachycardia pacing (DDDRP) in combination with managed ventricular pacing (MVP) reduces progression to permanent atrial fibrillation (AF) in patients with paroxysmal or persistent AF and bradycardia who need car...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
João de Sousa [verfasserIn] Pedro Marques [verfasserIn] Vítor Martins [verfasserIn] António Hipólito-Reis [verfasserIn] Luís Duarte [verfasserIn] Inês Joaquim [verfasserIn] Diogo Monteiro [verfasserIn] Giuseppe Boriani [verfasserIn] Claudia Wolff [verfasserIn] Andrea Grammatico [verfasserIn] Luigi Padeletti [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2018 |
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| Übergeordnetes Werk: |
In: Revista Portuguesa de Cardiologia (English Edition) - Elsevier, 2020, 37(2018), 12, Seite 973-978 |
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| Übergeordnetes Werk: |
volume:37 ; year:2018 ; number:12 ; pages:973-978 |
| Links: |
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| DOI / URN: |
10.1016/j.repce.2018.01.011 |
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| Katalog-ID: |
DOAJ003867145 |
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| 520 | |a Introduction: The MINERVA trial established that atrial preventive pacing and atrial antitachycardia pacing (DDDRP) in combination with managed ventricular pacing (MVP) reduces progression to permanent atrial fibrillation (AF) in patients with paroxysmal or persistent AF and bradycardia who need cardiac pacing, compared to standard dual-chamber pacing (DDDR). It was shown that AF-related health care utilization was significantly lower in the DDDRP + MVP group than in the control group. Cost analysis demonstrated significant savings related to this new algorithm, based on health care costs from the USA, Italy, Spain and the UK. Objective: To calculate the savings associated with reduced health care utilization due to enhanced pacing modalities in the Portuguese setting. Methods: The impact on costs was estimated based on tariffs for AF-related hospitalizations and costs for emergency department and outpatient visits in Portugal. Results: The MINERVA trial showed a 42% reduction in AF-related health care utilization thanks to the new algorithm. In Portugal, this represents a potential cost saving of 2323 euros per 100 patients in the first year and 17 118 euros over a 10-year period. Considering the number of patients who could benefit from this new algorithm, Portugal could save a total of 75 369 euros per year and 555 410 euros over 10 years. Additional savings could accrue if heart failure and stroke hospitalizations were considered. Conclusion: The combination of atrial preventive pacing, atrial antitachycardia pacing and an algorithm to minimize the detrimental effect of right ventricular pacing reduces recurrent and permanent AF. The new DDDRP + MVP pacing mode could contribute to significant costs savings in the Portuguese health care setting. Resumo: Introdução: Observamos no estudo MINERVA que a prevenção de pacing auricular e antitaquicardia (DDDRP), em combinação com algoritmos de redução de pacing ventricular (MVP), reduzem a fibrilhação auricular (FA) permanente em doentes com bradicardia, com FA permanente ou paroxística que necessitam de pacing cardíaco, quando comparado com a estimulação elétrica de dupla câmara (DDDR). De igual forma, a utilização de recursos hospitalares foi significativamente menor no grupo DDDRP+MVP comparativamente ao grupo de controlo. Objetivo: Calcular as poupanças associadas à menor utilização de recursos hospitalares em Portugal com a utilização deste novo algoritmo. Métodos: O impacto nos custos foi estimado considerando o preço definido para a hospitalização associada à FA, o custo da urgência e das consultas em Portugal. Resultados: Foi estimada uma redução de 42% na utilização de recursos hospitalares com o novo algoritmo. Em Portugal, este resultado representa uma poupança de 2.323€ por cada 100 doentes no primeiro ano de utilização e um total de 17.118€ ao final de dez anos. Considerando o número de doentes que podem beneficiar deste algoritmo, existe um potencial de poupança de 75.369€ por ano e de 555.410€ em dez anos. Estas poupanças poderão ser superiores se forem considerados os custos de hospitalização decorrentes da insuficiência cardíaca e AVC. Conclusão: A combinação de prevenção de pacing auricular e antitaquicardia e algoritmos de redução de pacing ventricular reduzem a FA permanente ou recorrente. Estes novos algoritmos de pacing podem contribuir de forma significativa para a redução dos custos hospitalares relacionados com FA em Portugal. Keywords: Atrial fibrillation, Bradycardia, Pacemaker algorithms, Health care cost, Palavras-chave: Fibrilhação auricular, Bradicardia, Algoritmos de pacing, Custos de saúde | ||
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| 700 | 0 | |a Luigi Padeletti |e verfasserin |4 aut | |
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10.1016/j.repce.2018.01.011 doi (DE-627)DOAJ003867145 (DE-599)DOAJ64055955527248ecaff1504d75bbf990 DE-627 ger DE-627 rakwb eng RC666-701 João de Sousa verfasserin aut Health care cost analysis of enhanced pacing modalities in bradycardia patients: Portuguese case study on the results of the MINERVA trial 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: The MINERVA trial established that atrial preventive pacing and atrial antitachycardia pacing (DDDRP) in combination with managed ventricular pacing (MVP) reduces progression to permanent atrial fibrillation (AF) in patients with paroxysmal or persistent AF and bradycardia who need cardiac pacing, compared to standard dual-chamber pacing (DDDR). It was shown that AF-related health care utilization was significantly lower in the DDDRP + MVP group than in the control group. Cost analysis demonstrated significant savings related to this new algorithm, based on health care costs from the USA, Italy, Spain and the UK. Objective: To calculate the savings associated with reduced health care utilization due to enhanced pacing modalities in the Portuguese setting. Methods: The impact on costs was estimated based on tariffs for AF-related hospitalizations and costs for emergency department and outpatient visits in Portugal. Results: The MINERVA trial showed a 42% reduction in AF-related health care utilization thanks to the new algorithm. In Portugal, this represents a potential cost saving of 2323 euros per 100 patients in the first year and 17 118 euros over a 10-year period. Considering the number of patients who could benefit from this new algorithm, Portugal could save a total of 75 369 euros per year and 555 410 euros over 10 years. Additional savings could accrue if heart failure and stroke hospitalizations were considered. Conclusion: The combination of atrial preventive pacing, atrial antitachycardia pacing and an algorithm to minimize the detrimental effect of right ventricular pacing reduces recurrent and permanent AF. The new DDDRP + MVP pacing mode could contribute to significant costs savings in the Portuguese health care setting. Resumo: Introdução: Observamos no estudo MINERVA que a prevenção de pacing auricular e antitaquicardia (DDDRP), em combinação com algoritmos de redução de pacing ventricular (MVP), reduzem a fibrilhação auricular (FA) permanente em doentes com bradicardia, com FA permanente ou paroxística que necessitam de pacing cardíaco, quando comparado com a estimulação elétrica de dupla câmara (DDDR). De igual forma, a utilização de recursos hospitalares foi significativamente menor no grupo DDDRP+MVP comparativamente ao grupo de controlo. Objetivo: Calcular as poupanças associadas à menor utilização de recursos hospitalares em Portugal com a utilização deste novo algoritmo. Métodos: O impacto nos custos foi estimado considerando o preço definido para a hospitalização associada à FA, o custo da urgência e das consultas em Portugal. Resultados: Foi estimada uma redução de 42% na utilização de recursos hospitalares com o novo algoritmo. Em Portugal, este resultado representa uma poupança de 2.323€ por cada 100 doentes no primeiro ano de utilização e um total de 17.118€ ao final de dez anos. Considerando o número de doentes que podem beneficiar deste algoritmo, existe um potencial de poupança de 75.369€ por ano e de 555.410€ em dez anos. Estas poupanças poderão ser superiores se forem considerados os custos de hospitalização decorrentes da insuficiência cardíaca e AVC. Conclusão: A combinação de prevenção de pacing auricular e antitaquicardia e algoritmos de redução de pacing ventricular reduzem a FA permanente ou recorrente. Estes novos algoritmos de pacing podem contribuir de forma significativa para a redução dos custos hospitalares relacionados com FA em Portugal. Keywords: Atrial fibrillation, Bradycardia, Pacemaker algorithms, Health care cost, Palavras-chave: Fibrilhação auricular, Bradicardia, Algoritmos de pacing, Custos de saúde Diseases of the circulatory (Cardiovascular) system Pedro Marques verfasserin aut Vítor Martins verfasserin aut António Hipólito-Reis verfasserin aut Luís Duarte verfasserin aut Inês Joaquim verfasserin aut Diogo Monteiro verfasserin aut Giuseppe Boriani verfasserin aut Claudia Wolff verfasserin aut Andrea Grammatico verfasserin aut Luigi Padeletti verfasserin aut In Revista Portuguesa de Cardiologia (English Edition) Elsevier, 2020 37(2018), 12, Seite 973-978 (DE-627)684129663 (DE-600)2646972-8 21742049 nnns volume:37 year:2018 number:12 pages:973-978 https://doi.org/10.1016/j.repce.2018.01.011 kostenfrei https://doaj.org/article/64055955527248ecaff1504d75bbf990 kostenfrei http://www.sciencedirect.com/science/article/pii/S2174204918304203 kostenfrei https://doaj.org/toc/2174-2049 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_647 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 37 2018 12 973-978 |
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10.1016/j.repce.2018.01.011 doi (DE-627)DOAJ003867145 (DE-599)DOAJ64055955527248ecaff1504d75bbf990 DE-627 ger DE-627 rakwb eng RC666-701 João de Sousa verfasserin aut Health care cost analysis of enhanced pacing modalities in bradycardia patients: Portuguese case study on the results of the MINERVA trial 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: The MINERVA trial established that atrial preventive pacing and atrial antitachycardia pacing (DDDRP) in combination with managed ventricular pacing (MVP) reduces progression to permanent atrial fibrillation (AF) in patients with paroxysmal or persistent AF and bradycardia who need cardiac pacing, compared to standard dual-chamber pacing (DDDR). It was shown that AF-related health care utilization was significantly lower in the DDDRP + MVP group than in the control group. Cost analysis demonstrated significant savings related to this new algorithm, based on health care costs from the USA, Italy, Spain and the UK. Objective: To calculate the savings associated with reduced health care utilization due to enhanced pacing modalities in the Portuguese setting. Methods: The impact on costs was estimated based on tariffs for AF-related hospitalizations and costs for emergency department and outpatient visits in Portugal. Results: The MINERVA trial showed a 42% reduction in AF-related health care utilization thanks to the new algorithm. In Portugal, this represents a potential cost saving of 2323 euros per 100 patients in the first year and 17 118 euros over a 10-year period. Considering the number of patients who could benefit from this new algorithm, Portugal could save a total of 75 369 euros per year and 555 410 euros over 10 years. Additional savings could accrue if heart failure and stroke hospitalizations were considered. Conclusion: The combination of atrial preventive pacing, atrial antitachycardia pacing and an algorithm to minimize the detrimental effect of right ventricular pacing reduces recurrent and permanent AF. The new DDDRP + MVP pacing mode could contribute to significant costs savings in the Portuguese health care setting. Resumo: Introdução: Observamos no estudo MINERVA que a prevenção de pacing auricular e antitaquicardia (DDDRP), em combinação com algoritmos de redução de pacing ventricular (MVP), reduzem a fibrilhação auricular (FA) permanente em doentes com bradicardia, com FA permanente ou paroxística que necessitam de pacing cardíaco, quando comparado com a estimulação elétrica de dupla câmara (DDDR). De igual forma, a utilização de recursos hospitalares foi significativamente menor no grupo DDDRP+MVP comparativamente ao grupo de controlo. Objetivo: Calcular as poupanças associadas à menor utilização de recursos hospitalares em Portugal com a utilização deste novo algoritmo. Métodos: O impacto nos custos foi estimado considerando o preço definido para a hospitalização associada à FA, o custo da urgência e das consultas em Portugal. Resultados: Foi estimada uma redução de 42% na utilização de recursos hospitalares com o novo algoritmo. Em Portugal, este resultado representa uma poupança de 2.323€ por cada 100 doentes no primeiro ano de utilização e um total de 17.118€ ao final de dez anos. Considerando o número de doentes que podem beneficiar deste algoritmo, existe um potencial de poupança de 75.369€ por ano e de 555.410€ em dez anos. Estas poupanças poderão ser superiores se forem considerados os custos de hospitalização decorrentes da insuficiência cardíaca e AVC. Conclusão: A combinação de prevenção de pacing auricular e antitaquicardia e algoritmos de redução de pacing ventricular reduzem a FA permanente ou recorrente. Estes novos algoritmos de pacing podem contribuir de forma significativa para a redução dos custos hospitalares relacionados com FA em Portugal. Keywords: Atrial fibrillation, Bradycardia, Pacemaker algorithms, Health care cost, Palavras-chave: Fibrilhação auricular, Bradicardia, Algoritmos de pacing, Custos de saúde Diseases of the circulatory (Cardiovascular) system Pedro Marques verfasserin aut Vítor Martins verfasserin aut António Hipólito-Reis verfasserin aut Luís Duarte verfasserin aut Inês Joaquim verfasserin aut Diogo Monteiro verfasserin aut Giuseppe Boriani verfasserin aut Claudia Wolff verfasserin aut Andrea Grammatico verfasserin aut Luigi Padeletti verfasserin aut In Revista Portuguesa de Cardiologia (English Edition) Elsevier, 2020 37(2018), 12, Seite 973-978 (DE-627)684129663 (DE-600)2646972-8 21742049 nnns volume:37 year:2018 number:12 pages:973-978 https://doi.org/10.1016/j.repce.2018.01.011 kostenfrei https://doaj.org/article/64055955527248ecaff1504d75bbf990 kostenfrei http://www.sciencedirect.com/science/article/pii/S2174204918304203 kostenfrei https://doaj.org/toc/2174-2049 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_647 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 37 2018 12 973-978 |
| allfields_unstemmed |
10.1016/j.repce.2018.01.011 doi (DE-627)DOAJ003867145 (DE-599)DOAJ64055955527248ecaff1504d75bbf990 DE-627 ger DE-627 rakwb eng RC666-701 João de Sousa verfasserin aut Health care cost analysis of enhanced pacing modalities in bradycardia patients: Portuguese case study on the results of the MINERVA trial 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: The MINERVA trial established that atrial preventive pacing and atrial antitachycardia pacing (DDDRP) in combination with managed ventricular pacing (MVP) reduces progression to permanent atrial fibrillation (AF) in patients with paroxysmal or persistent AF and bradycardia who need cardiac pacing, compared to standard dual-chamber pacing (DDDR). It was shown that AF-related health care utilization was significantly lower in the DDDRP + MVP group than in the control group. Cost analysis demonstrated significant savings related to this new algorithm, based on health care costs from the USA, Italy, Spain and the UK. Objective: To calculate the savings associated with reduced health care utilization due to enhanced pacing modalities in the Portuguese setting. Methods: The impact on costs was estimated based on tariffs for AF-related hospitalizations and costs for emergency department and outpatient visits in Portugal. Results: The MINERVA trial showed a 42% reduction in AF-related health care utilization thanks to the new algorithm. In Portugal, this represents a potential cost saving of 2323 euros per 100 patients in the first year and 17 118 euros over a 10-year period. Considering the number of patients who could benefit from this new algorithm, Portugal could save a total of 75 369 euros per year and 555 410 euros over 10 years. Additional savings could accrue if heart failure and stroke hospitalizations were considered. Conclusion: The combination of atrial preventive pacing, atrial antitachycardia pacing and an algorithm to minimize the detrimental effect of right ventricular pacing reduces recurrent and permanent AF. The new DDDRP + MVP pacing mode could contribute to significant costs savings in the Portuguese health care setting. Resumo: Introdução: Observamos no estudo MINERVA que a prevenção de pacing auricular e antitaquicardia (DDDRP), em combinação com algoritmos de redução de pacing ventricular (MVP), reduzem a fibrilhação auricular (FA) permanente em doentes com bradicardia, com FA permanente ou paroxística que necessitam de pacing cardíaco, quando comparado com a estimulação elétrica de dupla câmara (DDDR). De igual forma, a utilização de recursos hospitalares foi significativamente menor no grupo DDDRP+MVP comparativamente ao grupo de controlo. Objetivo: Calcular as poupanças associadas à menor utilização de recursos hospitalares em Portugal com a utilização deste novo algoritmo. Métodos: O impacto nos custos foi estimado considerando o preço definido para a hospitalização associada à FA, o custo da urgência e das consultas em Portugal. Resultados: Foi estimada uma redução de 42% na utilização de recursos hospitalares com o novo algoritmo. Em Portugal, este resultado representa uma poupança de 2.323€ por cada 100 doentes no primeiro ano de utilização e um total de 17.118€ ao final de dez anos. Considerando o número de doentes que podem beneficiar deste algoritmo, existe um potencial de poupança de 75.369€ por ano e de 555.410€ em dez anos. Estas poupanças poderão ser superiores se forem considerados os custos de hospitalização decorrentes da insuficiência cardíaca e AVC. Conclusão: A combinação de prevenção de pacing auricular e antitaquicardia e algoritmos de redução de pacing ventricular reduzem a FA permanente ou recorrente. Estes novos algoritmos de pacing podem contribuir de forma significativa para a redução dos custos hospitalares relacionados com FA em Portugal. Keywords: Atrial fibrillation, Bradycardia, Pacemaker algorithms, Health care cost, Palavras-chave: Fibrilhação auricular, Bradicardia, Algoritmos de pacing, Custos de saúde Diseases of the circulatory (Cardiovascular) system Pedro Marques verfasserin aut Vítor Martins verfasserin aut António Hipólito-Reis verfasserin aut Luís Duarte verfasserin aut Inês Joaquim verfasserin aut Diogo Monteiro verfasserin aut Giuseppe Boriani verfasserin aut Claudia Wolff verfasserin aut Andrea Grammatico verfasserin aut Luigi Padeletti verfasserin aut In Revista Portuguesa de Cardiologia (English Edition) Elsevier, 2020 37(2018), 12, Seite 973-978 (DE-627)684129663 (DE-600)2646972-8 21742049 nnns volume:37 year:2018 number:12 pages:973-978 https://doi.org/10.1016/j.repce.2018.01.011 kostenfrei https://doaj.org/article/64055955527248ecaff1504d75bbf990 kostenfrei http://www.sciencedirect.com/science/article/pii/S2174204918304203 kostenfrei https://doaj.org/toc/2174-2049 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_647 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 37 2018 12 973-978 |
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10.1016/j.repce.2018.01.011 doi (DE-627)DOAJ003867145 (DE-599)DOAJ64055955527248ecaff1504d75bbf990 DE-627 ger DE-627 rakwb eng RC666-701 João de Sousa verfasserin aut Health care cost analysis of enhanced pacing modalities in bradycardia patients: Portuguese case study on the results of the MINERVA trial 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: The MINERVA trial established that atrial preventive pacing and atrial antitachycardia pacing (DDDRP) in combination with managed ventricular pacing (MVP) reduces progression to permanent atrial fibrillation (AF) in patients with paroxysmal or persistent AF and bradycardia who need cardiac pacing, compared to standard dual-chamber pacing (DDDR). It was shown that AF-related health care utilization was significantly lower in the DDDRP + MVP group than in the control group. Cost analysis demonstrated significant savings related to this new algorithm, based on health care costs from the USA, Italy, Spain and the UK. Objective: To calculate the savings associated with reduced health care utilization due to enhanced pacing modalities in the Portuguese setting. Methods: The impact on costs was estimated based on tariffs for AF-related hospitalizations and costs for emergency department and outpatient visits in Portugal. Results: The MINERVA trial showed a 42% reduction in AF-related health care utilization thanks to the new algorithm. In Portugal, this represents a potential cost saving of 2323 euros per 100 patients in the first year and 17 118 euros over a 10-year period. Considering the number of patients who could benefit from this new algorithm, Portugal could save a total of 75 369 euros per year and 555 410 euros over 10 years. Additional savings could accrue if heart failure and stroke hospitalizations were considered. Conclusion: The combination of atrial preventive pacing, atrial antitachycardia pacing and an algorithm to minimize the detrimental effect of right ventricular pacing reduces recurrent and permanent AF. The new DDDRP + MVP pacing mode could contribute to significant costs savings in the Portuguese health care setting. Resumo: Introdução: Observamos no estudo MINERVA que a prevenção de pacing auricular e antitaquicardia (DDDRP), em combinação com algoritmos de redução de pacing ventricular (MVP), reduzem a fibrilhação auricular (FA) permanente em doentes com bradicardia, com FA permanente ou paroxística que necessitam de pacing cardíaco, quando comparado com a estimulação elétrica de dupla câmara (DDDR). De igual forma, a utilização de recursos hospitalares foi significativamente menor no grupo DDDRP+MVP comparativamente ao grupo de controlo. Objetivo: Calcular as poupanças associadas à menor utilização de recursos hospitalares em Portugal com a utilização deste novo algoritmo. Métodos: O impacto nos custos foi estimado considerando o preço definido para a hospitalização associada à FA, o custo da urgência e das consultas em Portugal. Resultados: Foi estimada uma redução de 42% na utilização de recursos hospitalares com o novo algoritmo. Em Portugal, este resultado representa uma poupança de 2.323€ por cada 100 doentes no primeiro ano de utilização e um total de 17.118€ ao final de dez anos. Considerando o número de doentes que podem beneficiar deste algoritmo, existe um potencial de poupança de 75.369€ por ano e de 555.410€ em dez anos. Estas poupanças poderão ser superiores se forem considerados os custos de hospitalização decorrentes da insuficiência cardíaca e AVC. Conclusão: A combinação de prevenção de pacing auricular e antitaquicardia e algoritmos de redução de pacing ventricular reduzem a FA permanente ou recorrente. Estes novos algoritmos de pacing podem contribuir de forma significativa para a redução dos custos hospitalares relacionados com FA em Portugal. Keywords: Atrial fibrillation, Bradycardia, Pacemaker algorithms, Health care cost, Palavras-chave: Fibrilhação auricular, Bradicardia, Algoritmos de pacing, Custos de saúde Diseases of the circulatory (Cardiovascular) system Pedro Marques verfasserin aut Vítor Martins verfasserin aut António Hipólito-Reis verfasserin aut Luís Duarte verfasserin aut Inês Joaquim verfasserin aut Diogo Monteiro verfasserin aut Giuseppe Boriani verfasserin aut Claudia Wolff verfasserin aut Andrea Grammatico verfasserin aut Luigi Padeletti verfasserin aut In Revista Portuguesa de Cardiologia (English Edition) Elsevier, 2020 37(2018), 12, Seite 973-978 (DE-627)684129663 (DE-600)2646972-8 21742049 nnns volume:37 year:2018 number:12 pages:973-978 https://doi.org/10.1016/j.repce.2018.01.011 kostenfrei https://doaj.org/article/64055955527248ecaff1504d75bbf990 kostenfrei http://www.sciencedirect.com/science/article/pii/S2174204918304203 kostenfrei https://doaj.org/toc/2174-2049 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_647 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 37 2018 12 973-978 |
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10.1016/j.repce.2018.01.011 doi (DE-627)DOAJ003867145 (DE-599)DOAJ64055955527248ecaff1504d75bbf990 DE-627 ger DE-627 rakwb eng RC666-701 João de Sousa verfasserin aut Health care cost analysis of enhanced pacing modalities in bradycardia patients: Portuguese case study on the results of the MINERVA trial 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: The MINERVA trial established that atrial preventive pacing and atrial antitachycardia pacing (DDDRP) in combination with managed ventricular pacing (MVP) reduces progression to permanent atrial fibrillation (AF) in patients with paroxysmal or persistent AF and bradycardia who need cardiac pacing, compared to standard dual-chamber pacing (DDDR). It was shown that AF-related health care utilization was significantly lower in the DDDRP + MVP group than in the control group. Cost analysis demonstrated significant savings related to this new algorithm, based on health care costs from the USA, Italy, Spain and the UK. Objective: To calculate the savings associated with reduced health care utilization due to enhanced pacing modalities in the Portuguese setting. Methods: The impact on costs was estimated based on tariffs for AF-related hospitalizations and costs for emergency department and outpatient visits in Portugal. Results: The MINERVA trial showed a 42% reduction in AF-related health care utilization thanks to the new algorithm. In Portugal, this represents a potential cost saving of 2323 euros per 100 patients in the first year and 17 118 euros over a 10-year period. Considering the number of patients who could benefit from this new algorithm, Portugal could save a total of 75 369 euros per year and 555 410 euros over 10 years. Additional savings could accrue if heart failure and stroke hospitalizations were considered. Conclusion: The combination of atrial preventive pacing, atrial antitachycardia pacing and an algorithm to minimize the detrimental effect of right ventricular pacing reduces recurrent and permanent AF. The new DDDRP + MVP pacing mode could contribute to significant costs savings in the Portuguese health care setting. Resumo: Introdução: Observamos no estudo MINERVA que a prevenção de pacing auricular e antitaquicardia (DDDRP), em combinação com algoritmos de redução de pacing ventricular (MVP), reduzem a fibrilhação auricular (FA) permanente em doentes com bradicardia, com FA permanente ou paroxística que necessitam de pacing cardíaco, quando comparado com a estimulação elétrica de dupla câmara (DDDR). De igual forma, a utilização de recursos hospitalares foi significativamente menor no grupo DDDRP+MVP comparativamente ao grupo de controlo. Objetivo: Calcular as poupanças associadas à menor utilização de recursos hospitalares em Portugal com a utilização deste novo algoritmo. Métodos: O impacto nos custos foi estimado considerando o preço definido para a hospitalização associada à FA, o custo da urgência e das consultas em Portugal. Resultados: Foi estimada uma redução de 42% na utilização de recursos hospitalares com o novo algoritmo. Em Portugal, este resultado representa uma poupança de 2.323€ por cada 100 doentes no primeiro ano de utilização e um total de 17.118€ ao final de dez anos. Considerando o número de doentes que podem beneficiar deste algoritmo, existe um potencial de poupança de 75.369€ por ano e de 555.410€ em dez anos. Estas poupanças poderão ser superiores se forem considerados os custos de hospitalização decorrentes da insuficiência cardíaca e AVC. Conclusão: A combinação de prevenção de pacing auricular e antitaquicardia e algoritmos de redução de pacing ventricular reduzem a FA permanente ou recorrente. Estes novos algoritmos de pacing podem contribuir de forma significativa para a redução dos custos hospitalares relacionados com FA em Portugal. Keywords: Atrial fibrillation, Bradycardia, Pacemaker algorithms, Health care cost, Palavras-chave: Fibrilhação auricular, Bradicardia, Algoritmos de pacing, Custos de saúde Diseases of the circulatory (Cardiovascular) system Pedro Marques verfasserin aut Vítor Martins verfasserin aut António Hipólito-Reis verfasserin aut Luís Duarte verfasserin aut Inês Joaquim verfasserin aut Diogo Monteiro verfasserin aut Giuseppe Boriani verfasserin aut Claudia Wolff verfasserin aut Andrea Grammatico verfasserin aut Luigi Padeletti verfasserin aut In Revista Portuguesa de Cardiologia (English Edition) Elsevier, 2020 37(2018), 12, Seite 973-978 (DE-627)684129663 (DE-600)2646972-8 21742049 nnns volume:37 year:2018 number:12 pages:973-978 https://doi.org/10.1016/j.repce.2018.01.011 kostenfrei https://doaj.org/article/64055955527248ecaff1504d75bbf990 kostenfrei http://www.sciencedirect.com/science/article/pii/S2174204918304203 kostenfrei https://doaj.org/toc/2174-2049 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_647 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 37 2018 12 973-978 |
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health care cost analysis of enhanced pacing modalities in bradycardia patients: portuguese case study on the results of the minerva trial |
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Health care cost analysis of enhanced pacing modalities in bradycardia patients: Portuguese case study on the results of the MINERVA trial |
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Introduction: The MINERVA trial established that atrial preventive pacing and atrial antitachycardia pacing (DDDRP) in combination with managed ventricular pacing (MVP) reduces progression to permanent atrial fibrillation (AF) in patients with paroxysmal or persistent AF and bradycardia who need cardiac pacing, compared to standard dual-chamber pacing (DDDR). It was shown that AF-related health care utilization was significantly lower in the DDDRP + MVP group than in the control group. Cost analysis demonstrated significant savings related to this new algorithm, based on health care costs from the USA, Italy, Spain and the UK. Objective: To calculate the savings associated with reduced health care utilization due to enhanced pacing modalities in the Portuguese setting. Methods: The impact on costs was estimated based on tariffs for AF-related hospitalizations and costs for emergency department and outpatient visits in Portugal. Results: The MINERVA trial showed a 42% reduction in AF-related health care utilization thanks to the new algorithm. In Portugal, this represents a potential cost saving of 2323 euros per 100 patients in the first year and 17 118 euros over a 10-year period. Considering the number of patients who could benefit from this new algorithm, Portugal could save a total of 75 369 euros per year and 555 410 euros over 10 years. Additional savings could accrue if heart failure and stroke hospitalizations were considered. Conclusion: The combination of atrial preventive pacing, atrial antitachycardia pacing and an algorithm to minimize the detrimental effect of right ventricular pacing reduces recurrent and permanent AF. The new DDDRP + MVP pacing mode could contribute to significant costs savings in the Portuguese health care setting. Resumo: Introdução: Observamos no estudo MINERVA que a prevenção de pacing auricular e antitaquicardia (DDDRP), em combinação com algoritmos de redução de pacing ventricular (MVP), reduzem a fibrilhação auricular (FA) permanente em doentes com bradicardia, com FA permanente ou paroxística que necessitam de pacing cardíaco, quando comparado com a estimulação elétrica de dupla câmara (DDDR). De igual forma, a utilização de recursos hospitalares foi significativamente menor no grupo DDDRP+MVP comparativamente ao grupo de controlo. Objetivo: Calcular as poupanças associadas à menor utilização de recursos hospitalares em Portugal com a utilização deste novo algoritmo. Métodos: O impacto nos custos foi estimado considerando o preço definido para a hospitalização associada à FA, o custo da urgência e das consultas em Portugal. Resultados: Foi estimada uma redução de 42% na utilização de recursos hospitalares com o novo algoritmo. Em Portugal, este resultado representa uma poupança de 2.323€ por cada 100 doentes no primeiro ano de utilização e um total de 17.118€ ao final de dez anos. Considerando o número de doentes que podem beneficiar deste algoritmo, existe um potencial de poupança de 75.369€ por ano e de 555.410€ em dez anos. Estas poupanças poderão ser superiores se forem considerados os custos de hospitalização decorrentes da insuficiência cardíaca e AVC. Conclusão: A combinação de prevenção de pacing auricular e antitaquicardia e algoritmos de redução de pacing ventricular reduzem a FA permanente ou recorrente. Estes novos algoritmos de pacing podem contribuir de forma significativa para a redução dos custos hospitalares relacionados com FA em Portugal. Keywords: Atrial fibrillation, Bradycardia, Pacemaker algorithms, Health care cost, Palavras-chave: Fibrilhação auricular, Bradicardia, Algoritmos de pacing, Custos de saúde |
| abstractGer |
Introduction: The MINERVA trial established that atrial preventive pacing and atrial antitachycardia pacing (DDDRP) in combination with managed ventricular pacing (MVP) reduces progression to permanent atrial fibrillation (AF) in patients with paroxysmal or persistent AF and bradycardia who need cardiac pacing, compared to standard dual-chamber pacing (DDDR). It was shown that AF-related health care utilization was significantly lower in the DDDRP + MVP group than in the control group. Cost analysis demonstrated significant savings related to this new algorithm, based on health care costs from the USA, Italy, Spain and the UK. Objective: To calculate the savings associated with reduced health care utilization due to enhanced pacing modalities in the Portuguese setting. Methods: The impact on costs was estimated based on tariffs for AF-related hospitalizations and costs for emergency department and outpatient visits in Portugal. Results: The MINERVA trial showed a 42% reduction in AF-related health care utilization thanks to the new algorithm. In Portugal, this represents a potential cost saving of 2323 euros per 100 patients in the first year and 17 118 euros over a 10-year period. Considering the number of patients who could benefit from this new algorithm, Portugal could save a total of 75 369 euros per year and 555 410 euros over 10 years. Additional savings could accrue if heart failure and stroke hospitalizations were considered. Conclusion: The combination of atrial preventive pacing, atrial antitachycardia pacing and an algorithm to minimize the detrimental effect of right ventricular pacing reduces recurrent and permanent AF. The new DDDRP + MVP pacing mode could contribute to significant costs savings in the Portuguese health care setting. Resumo: Introdução: Observamos no estudo MINERVA que a prevenção de pacing auricular e antitaquicardia (DDDRP), em combinação com algoritmos de redução de pacing ventricular (MVP), reduzem a fibrilhação auricular (FA) permanente em doentes com bradicardia, com FA permanente ou paroxística que necessitam de pacing cardíaco, quando comparado com a estimulação elétrica de dupla câmara (DDDR). De igual forma, a utilização de recursos hospitalares foi significativamente menor no grupo DDDRP+MVP comparativamente ao grupo de controlo. Objetivo: Calcular as poupanças associadas à menor utilização de recursos hospitalares em Portugal com a utilização deste novo algoritmo. Métodos: O impacto nos custos foi estimado considerando o preço definido para a hospitalização associada à FA, o custo da urgência e das consultas em Portugal. Resultados: Foi estimada uma redução de 42% na utilização de recursos hospitalares com o novo algoritmo. Em Portugal, este resultado representa uma poupança de 2.323€ por cada 100 doentes no primeiro ano de utilização e um total de 17.118€ ao final de dez anos. Considerando o número de doentes que podem beneficiar deste algoritmo, existe um potencial de poupança de 75.369€ por ano e de 555.410€ em dez anos. Estas poupanças poderão ser superiores se forem considerados os custos de hospitalização decorrentes da insuficiência cardíaca e AVC. Conclusão: A combinação de prevenção de pacing auricular e antitaquicardia e algoritmos de redução de pacing ventricular reduzem a FA permanente ou recorrente. Estes novos algoritmos de pacing podem contribuir de forma significativa para a redução dos custos hospitalares relacionados com FA em Portugal. Keywords: Atrial fibrillation, Bradycardia, Pacemaker algorithms, Health care cost, Palavras-chave: Fibrilhação auricular, Bradicardia, Algoritmos de pacing, Custos de saúde |
| abstract_unstemmed |
Introduction: The MINERVA trial established that atrial preventive pacing and atrial antitachycardia pacing (DDDRP) in combination with managed ventricular pacing (MVP) reduces progression to permanent atrial fibrillation (AF) in patients with paroxysmal or persistent AF and bradycardia who need cardiac pacing, compared to standard dual-chamber pacing (DDDR). It was shown that AF-related health care utilization was significantly lower in the DDDRP + MVP group than in the control group. Cost analysis demonstrated significant savings related to this new algorithm, based on health care costs from the USA, Italy, Spain and the UK. Objective: To calculate the savings associated with reduced health care utilization due to enhanced pacing modalities in the Portuguese setting. Methods: The impact on costs was estimated based on tariffs for AF-related hospitalizations and costs for emergency department and outpatient visits in Portugal. Results: The MINERVA trial showed a 42% reduction in AF-related health care utilization thanks to the new algorithm. In Portugal, this represents a potential cost saving of 2323 euros per 100 patients in the first year and 17 118 euros over a 10-year period. Considering the number of patients who could benefit from this new algorithm, Portugal could save a total of 75 369 euros per year and 555 410 euros over 10 years. Additional savings could accrue if heart failure and stroke hospitalizations were considered. Conclusion: The combination of atrial preventive pacing, atrial antitachycardia pacing and an algorithm to minimize the detrimental effect of right ventricular pacing reduces recurrent and permanent AF. The new DDDRP + MVP pacing mode could contribute to significant costs savings in the Portuguese health care setting. Resumo: Introdução: Observamos no estudo MINERVA que a prevenção de pacing auricular e antitaquicardia (DDDRP), em combinação com algoritmos de redução de pacing ventricular (MVP), reduzem a fibrilhação auricular (FA) permanente em doentes com bradicardia, com FA permanente ou paroxística que necessitam de pacing cardíaco, quando comparado com a estimulação elétrica de dupla câmara (DDDR). De igual forma, a utilização de recursos hospitalares foi significativamente menor no grupo DDDRP+MVP comparativamente ao grupo de controlo. Objetivo: Calcular as poupanças associadas à menor utilização de recursos hospitalares em Portugal com a utilização deste novo algoritmo. Métodos: O impacto nos custos foi estimado considerando o preço definido para a hospitalização associada à FA, o custo da urgência e das consultas em Portugal. Resultados: Foi estimada uma redução de 42% na utilização de recursos hospitalares com o novo algoritmo. Em Portugal, este resultado representa uma poupança de 2.323€ por cada 100 doentes no primeiro ano de utilização e um total de 17.118€ ao final de dez anos. Considerando o número de doentes que podem beneficiar deste algoritmo, existe um potencial de poupança de 75.369€ por ano e de 555.410€ em dez anos. Estas poupanças poderão ser superiores se forem considerados os custos de hospitalização decorrentes da insuficiência cardíaca e AVC. Conclusão: A combinação de prevenção de pacing auricular e antitaquicardia e algoritmos de redução de pacing ventricular reduzem a FA permanente ou recorrente. Estes novos algoritmos de pacing podem contribuir de forma significativa para a redução dos custos hospitalares relacionados com FA em Portugal. Keywords: Atrial fibrillation, Bradycardia, Pacemaker algorithms, Health care cost, Palavras-chave: Fibrilhação auricular, Bradicardia, Algoritmos de pacing, Custos de saúde |
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It was shown that AF-related health care utilization was significantly lower in the DDDRP + MVP group than in the control group. Cost analysis demonstrated significant savings related to this new algorithm, based on health care costs from the USA, Italy, Spain and the UK. Objective: To calculate the savings associated with reduced health care utilization due to enhanced pacing modalities in the Portuguese setting. Methods: The impact on costs was estimated based on tariffs for AF-related hospitalizations and costs for emergency department and outpatient visits in Portugal. Results: The MINERVA trial showed a 42% reduction in AF-related health care utilization thanks to the new algorithm. In Portugal, this represents a potential cost saving of 2323 euros per 100 patients in the first year and 17 118 euros over a 10-year period. 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De igual forma, a utilização de recursos hospitalares foi significativamente menor no grupo DDDRP+MVP comparativamente ao grupo de controlo. Objetivo: Calcular as poupanças associadas à menor utilização de recursos hospitalares em Portugal com a utilização deste novo algoritmo. Métodos: O impacto nos custos foi estimado considerando o preço definido para a hospitalização associada à FA, o custo da urgência e das consultas em Portugal. Resultados: Foi estimada uma redução de 42% na utilização de recursos hospitalares com o novo algoritmo. Em Portugal, este resultado representa uma poupança de 2.323€ por cada 100 doentes no primeiro ano de utilização e um total de 17.118€ ao final de dez anos. Considerando o número de doentes que podem beneficiar deste algoritmo, existe um potencial de poupança de 75.369€ por ano e de 555.410€ em dez anos. Estas poupanças poderão ser superiores se forem considerados os custos de hospitalização decorrentes da insuficiência cardíaca e AVC. Conclusão: A combinação de prevenção de pacing auricular e antitaquicardia e algoritmos de redução de pacing ventricular reduzem a FA permanente ou recorrente. Estes novos algoritmos de pacing podem contribuir de forma significativa para a redução dos custos hospitalares relacionados com FA em Portugal. 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