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

Abstract

Heart failure (HF) 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 CardioMEMS HF System, has been shown to be effective in reducing hospitalizations among New York Heart Association (NYHA) class III HF patients. The objective of this study was to estimate the cost-effectiveness of this remote monitoring technology compared to standard of care treatment for HF. A Markov cohort model relying on the CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients) clinical trial for mortality and hospitalization data, published sources for cost data, and a mix of CHAMPION 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 CardioMEMS HF System was found to be cost-effective, with an incremental cost-effectiveness ratio of $44,832 per quality-adjusted life year (QALY). 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/QALY exceeded $100,000. Compared with standard of care, the CardioMEMS HF System was cost-effective when leveraging trial data to populate the model.

Keywords: cost effectiveness; economic analysis; heart failure; monitoring; quality.

Conflict of interest statement

Authors Jordana K. Schmier and Kevin L. Ong are employed by Exponent. Exponent received a grant from St. Jude Medical to evaluate the cost‐effectiveness of its implantable remote monitoring system. Dr. Fonarow has served as a consultant to St. Jude Medical. St. Jude Medical has reviewed the manuscript prior to submission, but did not provide substantial scientific input.

© 2017 Wiley Periodicals, Inc.

Figures

Figure 1

Model structure. Abbreviations: HF, heart failure.

Figure 2

Tornado diagram. The vertical line the near center of the figure represents the base case result ($44,832/QALY). Abbreviations: QALY, quality‐adjusted life years; SoC, standard of care; trt, treatment.