Abraham, Charles

Dalal, Hasnain M

Davis, Russell

Doherty, Patrick

Frost, Julia

Greaves, Colin

Hayward , Christopher

Hillsdon, Melvyn

Jolly, Kate

Lang, Chim C

Miles , Jackie

Paul, Kevin

Sadler , Susannah

Singh, Sally J

Smith, Karen

Taylor, Rod S

Warren, Fiona C

Wingham, Jennifer

English

BackgroundThe REACH-HF (Rehabilitation EnAblement in CHronic Heart Failure) trial found that the REACH-HF home-based intervention resulted in a clinically meaningfulimprovement in disease-specific health-related quality of life in patients with reduced ejection fraction heart failure (HFrEF). The aim of this study was to assess the longterm cost-effectiveness of the addition of REACH-HF intervention or home-based CR to usual care compared to usual care alone in patients with HFrEF.Design and methodsA Markov model was developed using a patient lifetime horizon and integratingevidence from the REACH-HF trial, a systematic review/meta-analysis of randomised trials, estimates of mortality and hospital admission and UK costs at 2015/6 prices. Taking a UK National Health and Personal Social Services perspective we report the incremental cost per quality-adjusted life-year (QALY) gained, assessing uncertainty using probabilistic and deterministic sensitivity analyses.ResultsIn base case analysis, the REACH-HF intervention was associated with per patientmean QALY gain of 0.30 and an increased mean cost of £126 compared with usual care, resulting in a cost per QALY of £415. Probabilistic sensitivity analysis indicated a 77% probability that REACH-HF is cost effective versus usual care at a threshold of £20,000 per QALY. Results were similar for home-based CR versus usual care. Sensitivity analyses indicate the findings to be robust to changes in model assumptions and parametersConclusionsOur analyses indicate that the addition of the REACH-HF intervention and home-based CR programmes are likely to be cost-effective treatment options versus usual care alone in patients with HFrEF

Smith, Karen M

University of Birmingham Research Portal

The cost effectiveness of REACH-HF and home-based cardiac rehabilitation in the treatment of heart failure with reduced ejection fraction: a decision model-based analysis

http://pure-oai.bham.ac.uk/ws/files/57748837/REACH_AF_Health_econ_EJPC_accepted_version.pdf

The cost effectiveness of REACH-HF and home-based cardiac rehabilitation in the treatment of heart failure with reduced ejection fraction: a decision model-based analysis

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