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de Mello-Sampayo, F., Fiuza, M., Pinto, F. & Fonte, J. (2021). Cost-effectiveness of cardio-oncology clinical assessment for prevention of chemotherapy-induced cardiotoxicity. Revista Portuguesa de Cardiologia. 40 (7), 475-483

F. D. Sampayo et al.,  "Cost-effectiveness of cardio-oncology clinical assessment for prevention of chemotherapy-induced cardiotoxicity", in Revista Portuguesa de Cardiologia, vol. 40, no. 7, pp. 475-483, 2021

@article{sampayo2021_1733302188632,
	author = "de Mello-Sampayo, F. and Fiuza, M. and Pinto, F. and Fonte, J.",
	title = "Cost-effectiveness of cardio-oncology clinical assessment for prevention of chemotherapy-induced cardiotoxicity",
	journal = "Revista Portuguesa de Cardiologia",
	year = "2021",
	volume = "40",
	number = "7",
	doi = "10.1016/j.repc.2020.09.012",
	pages = "475-483",
	url = "https://www.sciencedirect.com/journal/revista-portuguesa-de-cardiologia"
}

TY  - JOUR
TI  - Cost-effectiveness of cardio-oncology clinical assessment for prevention of chemotherapy-induced cardiotoxicity
T2  - Revista Portuguesa de Cardiologia
VL  - 40
IS  - 7
AU  - de Mello-Sampayo, F.
AU  - Fiuza, M.
AU  - Pinto, F.
AU  - Fonte, J.
PY  - 2021
SP  - 475-483
SN  - 0870-2551
DO  - 10.1016/j.repc.2020.09.012
UR  - https://www.sciencedirect.com/journal/revista-portuguesa-de-cardiologia
AB  - Introduction
Cancer chemotherapy increases the risk of heart failure. This cost-effectiveness study analyzes cardio-oncology imaging assessment of left ventricular ejection fraction (LVEF) using a Portuguese healthcare payer perspective and a five-year time horizon.
Methods
Two cardioprotective strategies were assessed: universal cardioprotection (UCP) for all patients and cardioprotection initiated on diagnosis of LVEF-defined cardiotoxicity (EF-CTX). A Markov model, informed by the retrospective clinical course of breast cancer patients followed in a Portuguese public hospital, was developed to assess the cost-effectiveness of LVEF cardio-oncology imaging assessment. Data on transition probabilities, costs and utilities were retrieved from both the retrospective data and published literature to assess the cost-effectiveness of LVEF echocardiographic assessment. Costs and utilities of the cardioprotective strategies were assessed over a five-year range, using probabilistic sensitivity analyses.
Results
In the reference case of a 63-year-old breast cancer patient treated with cardioprotection initiated on diagnosis of EF-CTX, the five-year time horizon (4.22 QALYs and €2594 cost over five years) dominated UCP (3.42 QALYS and €3758 cost over five years). Under a time horizon of five years at a willingness-to-pay threshold of €22 986, over 65.7% of simulations provided additional QALYs. Monte Carlo simulation of the Markov model had no effect on the model's conclusions.
Conclusion
In the Portuguese public healthcare system and under specific hypotheses, from a healthcare payer perspective, EF-CTX-guided cardioprotection for patients at risk of chemotherapy-related cardiotoxicity provides more QALYs at lower cost than UCP.
ER  -