Conceptual model for early health technology assessment of current and novel heart valve interventions
Advances in the field of heart valve interventions, like tissue-engineered heart valves (TEHV). Prior to introduction in clinical practice, it is essential to perform early health technology assessment. We aim to develop a conceptual model (CM) that can be used to investigate the performance and costs requirements for TEHV to become cost-effective. Methods: After scoping the decision problem, a workgroup developed the draft CM based on clinical guidelines. This model was compared with existing models for cost-effectiveness of heart valve interventions, identified by systematic literature search. Next, it was discussed with a Delphi panel of cardiothoracic surgeons, cardiologists and a biomedical scientist (n=10). Results: The CM starts with the valve implantation. If patients survive the intervention, they can remain alive without complications, die from non-valve-related causes or experience a valve-related event. The events are separated in early and late events. After surviving an event, patients can experience another event or die due to non-valve-related causes. Predictors will include age, gender, NYHA class, left ventricular function and diabetes. Costs and quality adjusted life years are to be attached to health conditions to estimate long-term costs and health outcomes. Conclusions: We developed a CM that will serve as foundation of a decision-analytic model that can estimate the potential cost-effectiveness of TEHV in early development stages. This supports developers in deciding about further development of TEHV and identifies promising interventions that may result in faster take-up in clinical practice by clinicians and reimbursement by payers.
|Persistent URL||dx.doi.org/10.1136/openhrt-2016-000500, hdl.handle.net/1765/93875|
Huygens, S.A, Rutten-van Mölken, M.P.M.H, Bekkers, J.A, Bogers, A.J.J.C, Bouten, C.V.C, Chamuleau, S.A.J, … Takkenberg, J.J.M. (2016). Conceptual model for early health technology assessment of current and novel heart valve interventions. Open Heart, 3(2). doi:10.1136/openhrt-2016-000500