8 research outputs found
Costâutility analysis of radiofrequency ablation versus optimal medical therapy in managing supraventricular tachycardia among Filipinos
Abstract Background Radiofrequency ablation (RFA) is the standard of care in the management of supraventricular tachycardia (SVT). Its costâeffectiveness in an emerging Asian country has not been studied. Objectives A costâutility analysis of RFA versus optimal medical therapy (OMT) among Filipinos with SVT was conducted using the public healthcare provider's perspective. Methods A simulation cohort using a lifetime Markov model was constructed using patient interviews, a review of literature, and expert consensus. Three basic health states were defined: stable, SVT recurrence, and death. The incremental cost per qualityâadjusted life year (ICER) was determined for both arms. Utilities for the entry states were derived from patient interviews using the EQ5Dâ5L tool; utilities for other health states were taken from publications. Costs were assessed from the healthcare payer perspective. A sensitivity analysis was done. Results Base case analysis showed that RFA versus OMT is both highly costâeffective at 5âyears and over a lifetime. RFA at 5âyears costs about PhP276,913.58 (USD5,446) versus OMT of PhP151,550.95 (USD2,981) per patient. Discounted lifetime costs were PhP280,770.32 (USD5,522) for RFA, versus PhP259,549.74 (USD5,105) for OMT. There was improved quality of life with RFA (8.1 vs. 5.7 QALYs per patient). The 5âyear and lifetime incremental costâeffectiveness ratios were PhP148,741.40 (USD2,926) and Php15,000 (USD295), respectively. Sensitivity analysis showed 56.7% of simulations for RFA fell below a GDPâbenchmarked willingnessâtoâpay (WTP) threshold. Conclusion Despite the initial higher cost, RFA versus OMT for SVT is highly costâeffective from the Philippine public health payer's perspective