Cost-Effectiveness of Remote Cardiac Monitoring With the CardioMEMS Heart Failure System : Cost-effectiveness of CardioMEMS

Abstract

<p class="first" id="clc22696-para-0001">Heart failure ( <span style="fixed-case">HF</span>) is a leading cause of cardiovascular mortality in the United States and presents a substantial economic burden. A recently approved implantable wireless pulmonary artery pressure remote monitor, the <span style="fixed-case">CardioMEMS HF</span> System, has been shown to be effective in reducing hospitalizations among New York Heart Association ( <span style="fixed-case">NYHA</span>) class <span style="fixed-case">III HF</span> patients. The objective of this study was to estimate the cost‐effectiveness of this remote monitoring technology compared to standard of care treatment for <span style="fixed-case">HF</span>. A Markov cohort model relying on the <span style="fixed-case">CHAMPION</span> ( <span style="fixed-case">CardioMEMS</span> Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in <span style="fixed-case">NYHA</span> Class <span style="fixed-case">III</span> Heart Failure Patients) clinical trial for mortality and hospitalization data, published sources for cost data, and a mix of <span style="fixed-case">CHAMPION</span> data and published sources for utility data, was developed. The model compares outcomes over 5 years for implanted vs standard of care patients, allowing patients to accrue costs and utilities while they remain alive. Sensitivity analyses explored uncertainty in input parameters. The <span style="fixed-case">CardioMEMS HF</span> System was found to be cost‐effective, with an incremental cost‐effectiveness ratio of $44,832 per quality‐adjusted life year ( <span style="fixed-case">QALY</span>). Sensitivity analysis found the model was sensitive to the device cost and to whether mortality benefits were sustained, although there were no scenarios in which the cost/ <span style="fixed-case">QALY</span> exceeded $100,000. Compared with standard of care, the <span style="fixed-case">CardioMEMS HF</span> System was cost‐effective when leveraging trial data to populate the model. </p>