Cost-effectiveness analysis of radiofrequency renal denervation for uncontrolled hypertension in Spain
ABSTRACT Introduction and objectives: Radiofrequency (RF) renal denervation (RDN) has been shown to be a safe and effective treatment option for patients with uncontrolled hypertension. This analysis sought to explore the cost-effectiveness of this therapy in Spain. Methods: A decision-analytic Mark...
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2024-11-01
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| Series: | REC: Interventional Cardiology (English Ed.) |
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| author | Oriol Rodríguez-Leor Khoa N. Cao Fernando Jaén-Águila Tamara García-Camarero Carlos Mansilla-Morales Michael Kolovetsios María Álvarez-Orozco José Antonio García-Donaire Jan B. Pietzsch |
| author_facet | Oriol Rodríguez-Leor Khoa N. Cao Fernando Jaén-Águila Tamara García-Camarero Carlos Mansilla-Morales Michael Kolovetsios María Álvarez-Orozco José Antonio García-Donaire Jan B. Pietzsch |
| author_sort | Oriol Rodríguez-Leor |
| collection | DOAJ |
| description | ABSTRACT Introduction and objectives: Radiofrequency (RF) renal denervation (RDN) has been shown to be a safe and effective treatment option for patients with uncontrolled hypertension. This analysis sought to explore the cost-effectiveness of this therapy in Spain. Methods: A decision-analytic Markov model projected clinical events, quality-adjusted life years (QALY) and costs over the patients’ lifetime. Treatment effectiveness in the base case analysis was informed by the change in office systolic blood pressure observed in the full cohort of the SPYRAL HTN-ON MED trial (–4.9 mmHg vs sham control). Alternate scenarios were calculated for effect sizes reported in the HTN-ON MED subcohort of patients on 3 antihypertensive medications treated outside the United States, the HTN-OFF MED trial, and the Global SYMPLICITY Registry high-risk and very high-risk cohorts. The analysis was conducted from the Spanish National Health System perspective and a willingness-to-pay a threshold of €25 000 per QALY gained was considered. Results: RF RDN therapy resulted in clinical event reductions (10-year relative risk 0.80 for stroke, 0.88 for myocardial infarction, and 0.72 for heart failure) and a lifetime gain of 0.35 (13.99 vs 13.63) QALYs. Incremental lifetime costs were €5335 (€26 381 vs €21 045), resulting in an incremental cost-effectiveness ratio of €15 057 per QALY gained. Cost-effectiveness was further improved among all the other clinical evidence scenarios. Conclusions: The results of this study suggest that RF RDN can provide a cost-effective alternative in the treatment of uncontrolled hypertension in Spain. |
| format | Article |
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| institution | OA Journals |
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| language | English |
| publishDate | 2024-11-01 |
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| series | REC: Interventional Cardiology (English Ed.) |
| spelling | doaj-art-fdcffe49f8d34cb08fec46356400c6fe2025-08-20T02:14:39ZengPermanyerREC: Interventional Cardiology (English Ed.)2604-73222024-11-016430531210.24875/RECICE.M24000475Cost-effectiveness analysis of radiofrequency renal denervation for uncontrolled hypertension in SpainOriol Rodríguez-Leor0Khoa N. Cao1Fernando Jaén-Águila2Tamara García-Camarero3Carlos Mansilla-Morales4Michael Kolovetsios5María Álvarez-Orozco6José Antonio García-Donaire7Jan B. Pietzsch8Institut del Cor (ICOR), Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain Anne M.Wing Tech Inc., Menlo Park, California, United StatesUnidad de Riesgo Vascular, Servicio de Medicina Interna, Hospital Virgen de las Nieves, Granada, SpainUnidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, SpainHealth Economics & Outcomes Research, Medtronic Ibérica S.A., Madrid, SpainHealth Economics, Policy, and Reimbursement, Medtronic International Trading Sàrl, Tolochenaz, SwitzerlandHealth Economics & Outcomes Research, Medtronic Ibérica S.A., Madrid, SpainUnidad de Hipertensión y Riesgo Vascular, Servicio de Medicina Interna, Hospital Clínico San Carlos, Madrid, SpainWing Tech Inc., Menlo Park, California, United StatesABSTRACT Introduction and objectives: Radiofrequency (RF) renal denervation (RDN) has been shown to be a safe and effective treatment option for patients with uncontrolled hypertension. This analysis sought to explore the cost-effectiveness of this therapy in Spain. Methods: A decision-analytic Markov model projected clinical events, quality-adjusted life years (QALY) and costs over the patients’ lifetime. Treatment effectiveness in the base case analysis was informed by the change in office systolic blood pressure observed in the full cohort of the SPYRAL HTN-ON MED trial (–4.9 mmHg vs sham control). Alternate scenarios were calculated for effect sizes reported in the HTN-ON MED subcohort of patients on 3 antihypertensive medications treated outside the United States, the HTN-OFF MED trial, and the Global SYMPLICITY Registry high-risk and very high-risk cohorts. The analysis was conducted from the Spanish National Health System perspective and a willingness-to-pay a threshold of €25 000 per QALY gained was considered. Results: RF RDN therapy resulted in clinical event reductions (10-year relative risk 0.80 for stroke, 0.88 for myocardial infarction, and 0.72 for heart failure) and a lifetime gain of 0.35 (13.99 vs 13.63) QALYs. Incremental lifetime costs were €5335 (€26 381 vs €21 045), resulting in an incremental cost-effectiveness ratio of €15 057 per QALY gained. Cost-effectiveness was further improved among all the other clinical evidence scenarios. Conclusions: The results of this study suggest that RF RDN can provide a cost-effective alternative in the treatment of uncontrolled hypertension in Spain.https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=1334Denervation Hypertension Cost-effectiveness analysis Spain |
| spellingShingle | Oriol Rodríguez-Leor Khoa N. Cao Fernando Jaén-Águila Tamara García-Camarero Carlos Mansilla-Morales Michael Kolovetsios María Álvarez-Orozco José Antonio García-Donaire Jan B. Pietzsch Cost-effectiveness analysis of radiofrequency renal denervation for uncontrolled hypertension in Spain REC: Interventional Cardiology (English Ed.) Denervation Hypertension Cost-effectiveness analysis Spain |
| title | Cost-effectiveness analysis of radiofrequency renal denervation for uncontrolled hypertension in Spain |
| title_full | Cost-effectiveness analysis of radiofrequency renal denervation for uncontrolled hypertension in Spain |
| title_fullStr | Cost-effectiveness analysis of radiofrequency renal denervation for uncontrolled hypertension in Spain |
| title_full_unstemmed | Cost-effectiveness analysis of radiofrequency renal denervation for uncontrolled hypertension in Spain |
| title_short | Cost-effectiveness analysis of radiofrequency renal denervation for uncontrolled hypertension in Spain |
| title_sort | cost effectiveness analysis of radiofrequency renal denervation for uncontrolled hypertension in spain |
| topic | Denervation Hypertension Cost-effectiveness analysis Spain |
| url | https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=1334 |
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