Cost of Ventricular Assist Devices Can We Afford The Progress?
Cost of Ventricular Assist Devices Can We Afford The Progress?
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DOI：
10.1161/circulationaha.112.139824
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发表时间：
2013-02-12
期刊：
影响因子：
37.8
通讯作者：
Rogers, Joseph
中科院分区：
文献类型：
--
作者：
Miller, Leslie W.;Guglin, Maya;Rogers, Joseph
2013年2月12日，744发行量增加。13 HF中超出医疗管理的干预更昂贵。植入式心律转复除颤器的成本增加，起价为71 700美元。14心脏起搏治疗可改善生活质量，并可能对生存率产生有利影响，估计每QALY的增量成本效益比为40 000英镑（62 000美元）。15对各国成本和成本效益的解释不像货币换算那么简单，应视为粗略的近似值。在LVAD之前，心脏移植是最昂贵的，尽管是最确定的HF治疗。在哥伦比亚大学医学中心进行心脏移植并随访120天的总费用为150 000美元。[16]尽管费用高昂，但心脏移植的社会成本永远不会高得令人望而却步，因为移植的数量主要取决于有限的供体心脏。在这个国家，每年至少有16500人适合进行心脏移植，但每年2200英镑的供体心脏供应不足，限制了手术的数量。
744 Circulation February 12, 2013 gained. 13 Interventions beyond medical management in HF are more expensive. Implantable cardioverter defibrillators are associated with an incremental cost that starts at $71 700. 14 Cardiac resynchronization therapy, which provides improvement in quality of life and may favorably affect survival has an estimated incremental cost-effectiveness ratio of£ 40 000 (≈ $62 000) per QALY. 15 Interpretation of costs and cost effectiveness across countries is not as simple as currency conversion and should be considered a rough approximation. Heart transplant has been the most expensive—although the most definitive—HF treatment before the LVADs. The overall cost of heart transplant with 120 days follow-up at Columbia University Medical Center was≈ $150 000. 16 Despite its expense, the societal cost of heart transplant will never be prohibitively high simply because the volume of transplantations is primarily determined by the limited availability of donor hearts. At least 16 500 individuals per year in this country would be suitable candidates for cardiac transplant17 but the scarce supply of donor hearts at≈ 2200 a year limits the number of procedures performed.