Econix Research Analysis and Consulting Corporation, Teknopark, Samsun, Turkey.
Department of Cardiology, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey.
Anatol J Cardiol. 2022 Mar;26(3):198-209. doi: 10.5152/AnatolJCardiol.2021.406.
Tricuspid regurgitation is a condition that affects 1.6 million patients in the United States and is independently associated with morbidity and mortality. The TriClip™ procedure repairs the tricuspid valve without the need for open-heart surgery. The aim of this study is to evaluate the cost-effectiveness of TriClip™ treatment in patients with advanced tricuspid regurgitation from the Turkish reimbursement agency perspective.
Within the scope of this study, the general literature was searched in order to reach data on tricuspid regurgitation. The utilization of health care services used in the expert panel was re-calculated with the current reimbursement costs to determine the cost of heart failure in Turkey. In this study, Markov analysis, Tornado analysis, cost-effectiveness analysis, and partitioned survival analysis have been performed to determine whether TriClip™ is an effective treatment method compared to medication treatment.
In according to calculations, 5-year survival rate was found as 49.91% for medication treatment and 57.64% for TriClip™ treatment. According to the analysis performed, the cost of medication treatment was calculated as €3879.72 and TriClip™ Transcatheter Tricuspid Valve Repair System treatment as €25 661.15 for a 60-month period in patients with tricuspid regurgitation and New York Heart Association III-IV. In the calculation, it was found that TriClip™ treatment gave patients an average of 1.64 life years and it was found to be cost-effective compared to medication treatment.
Considering the positive effect of TriClip™ treatment on patients with tricuspid regurgitation in terms of mortality and regression of the heart failure stage, as recommended in the guidelines, widespread of its use has great importance.
三尖瓣反流影响美国 160 万患者，与发病率和死亡率独立相关。TriClip™ 手术无需开胸即可修复三尖瓣。本研究旨在从土耳其报销机构的角度评估 TriClip™ 治疗晚期三尖瓣反流的成本效益。
在这项研究的范围内，广泛搜索了一般文献，以获取三尖瓣反流的数据。重新计算了专家小组使用的医疗保健服务的使用情况，以确定土耳其心力衰竭的成本。在这项研究中，进行了马尔可夫分析、龙卷风分析、成本效益分析和分割生存分析，以确定与药物治疗相比，TriClip™ 是否是一种有效的治疗方法。
根据计算，药物治疗的 5 年生存率为 49.91%，TriClip™ 治疗的生存率为 57.64%。根据进行的分析，计算出药物治疗的成本为 3879.72 欧元，TriClip™ 经导管三尖瓣修复系统治疗的成本为 25661.15 欧元，用于 60 个月内有三尖瓣反流和纽约心脏协会 III-IV 级的患者。在计算中，发现 TriClip™ 治疗使患者的平均寿命延长了 1.64 年，与药物治疗相比具有成本效益。
考虑到 TriClip™ 治疗在死亡率和心力衰竭阶段逆转方面对三尖瓣反流患者的积极影响，正如指南所建议的那样，广泛应用 TriClip™ 具有重要意义。
