Budget impact of using Impella 5.0 device for cardiogenic shock: savings projected in France

Abstract

Introduction of the Impella 5.0 mechanical circulatory support (MCS) device into clinical practice in France for the management of cardiogenic shock is likely to be associated with cost savings, report researchers from France. The researchers used a budget-impact model to determine the budget impact associated with the introduction of the Impella 5.0 device into clinical practice in patients with left ventricular refractory cardiogenic shock requiring temporary MCS, compared with current clinical practice (veno-arterial extracorporeal membrane oxygenation [VAECMO]).* The model was informed by clinical input data obtained from expert opinion and observational studies. The analysis was performed from the perspective of the national health insurer in France. The model projected that the introduction of Impella 5.0 would be associated with total savings of €4.3 million over a 5-year time horizon, compared with current clinical practice. Savings were evident from year 1 onwards. At a projected market share of 20% relative to VA-ECMO in year 1, total annual savings generated by the use of Impella 5.0 were estimated at €375 600 in year 1 (€616 per patient), increasing to €1.3 million in year 5 (€2155 per patient) at a projected market share of 70%. The estimated savings associated with the introduction of Impella 5.0 were mainly driven by the lower incidence of device-related complications and shorter length of stay. Sensitivity analyses showed that the results were highly sensitive to assumptions relating to the length of stay with VA-ECMO.