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DyeVert™ PLUS EZ System for Preventing Contrast-Induced Acute Kidney Injury in Patients Undergoing Diagnostic Coronary Angiography and/or Percutaneous Coronary Intervention: A UK-Based Cost–Utility Analysis

Author

Listed:
  • Mehdi Javanbakht

    (Optimax Access UK Ltd, Market Access Consultancy
    Device Access UK Ltd, Market Access Consultancy, University of Southampton Science Park, Kenneth Dibben House)

  • Mohsen Rezaei Hemami

    (PenTAG Health Technology Assessment, University of Exeter)

  • Atefeh Mashayekhi

    (Optimax Access UK Ltd, Market Access Consultancy
    Device Access UK Ltd, Market Access Consultancy, University of Southampton Science Park, Kenneth Dibben House)

  • Michael Branagan-Harris

    (Device Access UK Ltd, Market Access Consultancy, University of Southampton Science Park, Kenneth Dibben House)

  • Azfar Zaman

    (Freeman Hospital)

  • Yahya Al-Najjar

    (Manchester University)

  • Donal O’Donoghue

    (Manchester University)

  • Farzin Fath-Ordoubadi

    (Manchester University)

  • Stephen Wheatcroft

    (Leeds Teaching Hospitals NHS Trust)

Abstract

Background Contrast-induced acute kidney injury (CI-AKI) is a complication commonly associated with invasive angiographic procedures and is considered the leading cause of hospital-acquired acute kidney injury. CI-AKI can lead to a prolonged hospital stay, with a substantial economic impact, and increased mortality. The DyeVert™ PLUS EZ system (FDA approved and CE marked) is a device that has been developed to divert a portion of the theoretical injected contrast media volume (CMV), reducing the overall volume of contrast media injected and aortic reflux, and potentially improving long-term health outcomes. Objectives To assess the long-term costs and health outcomes associated with the introduction of the DyeVert™ PLUS EZ system into the UK health care service for the prevention of CI-AKI in a cohort of patients with chronic kidney disease (CKD) stage 3–4 undergoing diagnostic coronary angiography (DAG) and/or percutaneous coronary intervention (PCI), and to compare these costs and outcomes with those of the current practice. Methods A de novo economic model was developed based on the current pathway of managing patients undergoing DAG and/or PCI and on evidence related to the clinical effectiveness of DyeVert™ in terms of its impact on relevant clinical outcomes and health service resource use. Clinical data used to populate the model were derived from the literature or were based on assumptions informed by expert clinical input. Costs included in the model were from the NHS and personal social services perspective and obtained from the literature and UK-based routine sources. Probabilistic distributions were assigned to the majority of model parameters so that a probabilistic analysis could be undertaken, while deterministic sensitivity analyses were also carried out to explore the impact of key parameter variation on the model results. Results Base-case results indicate that the intervention leads to cost savings (− £435) and improved effectiveness (+ 0.028 QALYs) over the patient’s lifetime compared with current practice. Output from the probabilistic analysis points to a high likelihood of the intervention being cost-effective across presented willingness-to-pay (WTP) thresholds. The overall long-term cost saving for the NHS associated with the introduction of the DyeVert™ PLUS EZ system is over £19.7 million for each annual cohort of patients. The cost savings are mainly driven by a lower risk of subsequent diseases and their associated costs. Conclusions The introduction of the DyeVert™ PLUS EZ system has the potential to reduce costs for the health care service and yield improved clinical outcomes for patients with CKD stage 3–4 undergoing angiographic procedures.

Suggested Citation

  • Mehdi Javanbakht & Mohsen Rezaei Hemami & Atefeh Mashayekhi & Michael Branagan-Harris & Azfar Zaman & Yahya Al-Najjar & Donal O’Donoghue & Farzin Fath-Ordoubadi & Stephen Wheatcroft, 2020. "DyeVert™ PLUS EZ System for Preventing Contrast-Induced Acute Kidney Injury in Patients Undergoing Diagnostic Coronary Angiography and/or Percutaneous Coronary Intervention: A UK-Based Cost–Utility An," PharmacoEconomics - Open, Springer, vol. 4(3), pages 459-472, September.
    • Handle: RePEc:spr:pharmo:v:4:y:2020:i:3:d:10.1007_s41669-020-00195-x
    DOI: 10.1007/s41669-020-00195-x
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    References listed on IDEAS

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    1. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884.
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    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Rita Faria’s journal round-up for 14th September 2020
      by Rita Faria in The Academic Health Economists' Blog on 2020-09-14 11:00:07

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