title: Pulmonary artery pressure‐guided heart failure management: US cost‐effectiveness analyses using the results of the CHAMPION clinical trial Cost-effectiveness of a text message programme for the prevention of recurrent cardiovascular events
abstract: Abstract Aims Haemodynamic‐guided  heart failure ( HF ) management effectively reduces decompensation events and need for hospitalizations . The economic benefit of clinical improvement requires further study . Methods and results An estimate of the cost‐effectiveness of haemodynamic‐guided HF management was made based on observations published in the r and omized , prospect i ve single‐blinded CHAMPION trial . A comprehensive analysis was performed including healthcare utilization event rates , survival , and quality of life demonstrated in the r and omized portion of the trial ( 18 months ) . Markov modelling with Monte Carlo simulation was used to approximate comprehensive costs and quality ‐adjusted life years ( QALYs ) from a payer perspective . Unit costs were estimated using the Truven Health MarketScan data base from April 2008 to March 2013 . Over a 5‐year horizon , patients in the Treatment group had average QALYs of 2.56 with a total cost of US$ 56 974 ; patients in the Control group had QALYs of 2.16 with a total cost of US$ 52 149 . The incremental cost‐effectiveness ratio ( ICER ) was US$ 12 262 per QALY . Using comprehensive cost modelling , including all anticipated costs of HF and non‐HF hospitalizations , physician visits , prescription drugs , long‐term care , and outpatient hospital visits over 5 years , the Treatment group had a total cost of US$ 212 004 and the Control group had a total cost of US$ 200 360 . The ICER was US$ 29 593 per QALY . Conclusions St and ard economic modelling suggests that pulmonary artery pressure‐guided management of HF using the CardioMEMS ™ HF System is cost‐effective from the US‐payer perspective . This analysis provides the background for further modelling in specific country healthcare systems and cost structures Objective To estimate the cost-effectiveness of Tobacco , Exercise and Diet Messages ( TEXT ME ) , a text message-based intervention that provides advice , motivation , information and support to improve health-related behaviours . Methods A lifetime Markov model was used to estimate major vascular events ( myocardial infa rct ions and strokes ) avoided , quality -adjusted life years ( QALYs ) gained , costs to the health system and the incremental cost per QALY gained . The model was informed by data from a r and omised controlled trial of TEXT ME , with evidence from systematic review s and meta-analyses used to estimate the effects of changes in risk factors on the risk of major vascular events . Expected costs and health outcomes were estimated with uncertainty surrounding these characterised using probabilistic sensitivity analysis and a number of scenario analyses . Results For a target population of 50 000 patients with documented coronary heart disease , the intervention is expected to lead to 563 fewer myocardial infa rct ions , 361 fewer strokes and 1143 additional QALYs .  TEXT ME is expected to lead to an overall saving of $ 10.56 million for the health system over the patients ’ lifetimes . The intervention can therefore be considered cost-saving and health-improving . Neither parameter nor structural uncertainty had a significant impact on the conclusion that TEXT ME is cost-effective . Conclusions The provision of TEXT ME is predicted to lead to better health outcomes and an overall saving in costs for the health system . Trial registration number anzctr.org.au identifier : ACTRN12611000161921
target: This study is the first systematic review of decision analytic model-based cost-effectiveness analyses of DHIs in the management of CVDs .
  All the included studies found the DHIs to be cost-effective
background: BACKGROUND With the advancement in information technology and mobile internet , digital health interventions ( DHIs ) are improving the care of cardiovascular diseases ( CVDs ) .
  The impact of DHIs on cost-effective management of CVDs has been examined using the decision analytic model-based health technology assessment approach .
  OBJECTIVE The aim of this study was to perform a systematic review of the decision analytic model-based studies evaluating the cost-effectiveness of DHIs on the management of CVDs .