■在罗马尼亚的主动脉瓣狭窄(AS)患者中使用牛心包主动脉生物假体(BPAB)或机械瓣膜(MV)的预算影响分析。
■使用具有分区生存模型的决策树来预测在主动脉瓣置换(AVR)手术中使用BPAB(Carpentier-EdwardsPerimountMagnaEaseValve)或MV的财务结果。各种资源消耗的预算影响,包括禁用中风,重新操作,轻微的血栓栓塞事件,大出血,心内膜炎,抗凝治疗和监测,对两种瓣膜的超声心动图评估进行了比较.对投入成本和概率进行了单向敏感性分析(OWSA)。
■使用BPAB与MV相比,由于同比节省了增量,因此接近预算中立性。BPAB的初始外科手术和再次手术费用被Acenocoumarol使用的节省所抵消,禁用笔划,大出血,轻微的血栓栓塞事件,和抗凝并发症。由于瓣膜购置成本较高,每位患者的初始手术成本为BPAB高出460欧元,尽管这被住院时间缩短部分抵消。OWSA显示,总的程序成本,包括住院时间,是模型中的主要成本动因。
■结果受到DRG系统中成本数据聚合的限制,排除消耗品和资本设备使用的成本,可能低估了门诊并发症的费用,事件发生率的年龄相关变化,和阀门的耐久性。
■在罗马尼亚采用BPAB作为AS患者的治疗选择可以节省成本和长期经济效益。通过降低手术成本和增加抗凝治疗成本,BPAB提供了一个预算中立的选项,可以帮助医疗保健提供者,政策制定者,在罗马尼亚,患者也应对日益增长的AS负担。
UNASSIGNED: An analysis of the budget impact of using a bovine pericardial aortic bioprosthesis (BPAB) or a mechanical valve (MV) in aortic stenosis (AS) patients in Romania.
UNASSIGNED: A decision-tree with a partitioned survival model was used to predict the financial outcomes of using either a BPAB (the Carpentier-Edwards Perimount Magna Ease Valve) or MV in aortic valve replacement (AVR) procedure over a 5-year period. The budget impact of various resource consumption including disabling strokes, reoperations, minor thromboembolic events, major bleeding, endocarditis, anticoagulation treatment and monitoring, and echocardiogram assessments were compared for both types of valves. One-way sensitivity analyses (OWSA) were conducted on the input costs and probabilities.
UNASSIGNED: The use of BPAB compared to MV approaches budget neutrality due to incremental savings year-on-year. The initial surgical procedure and reoperation costs for BPAB are offset by savings in acenocoumarol use, disabling strokes, major bleeding, minor thromboembolic events, and anticoagulation complications. The cost of the initial procedure per patient is 460 euros higher for a BPAB due to the higher valve acquisition cost, although this is partially offset by a shorter hospital stay. The OWSA shows that the total procedure costs, including the hospital stay, are the primary cost drivers in the model.
UNASSIGNED: Results are limited by cost data aggregation in the DRG system, exclusion of costs for consumables and capital equipment use, possible underestimation of outpatient complication costs, age-related variations of event rates, and valve durability.
UNASSIGNED: Adopting BPAB as a treatment option for AS patients in Romania can lead to cost savings and long-term economic benefits. By mitigating procedure costs and increasing anticoagulation treatment costs, BPAB offers a budget-neutral option that can help healthcare providers, policymakers, and patients alike manage the growing burden of AS in Romania.