Figures
- FIGURE 1
States and transitions in the Markov model. The state “After diagnosis” is also split up by type of treatment (pulmonary endarterectomy, balloon pulmonary angioplasty, pulmonary arterial hypertension-targeted and no treatment). Utilities and costs are modelled depending on health state, treatment and time since diagnosis. CTEPH: chronic thromboembolic pulmonary hypertension.
- FIGURE 2
Average healthcare expenses per treatment group in years before and after chronic thromboembolic pulmonary hypertension (CTEPH) diagnosis for the base case analysis, distinguishing hospital and medication costs. PEA: pulmonary endarterectemy; BPA: balloon pulmonary angioplasty; PAH: pulmonary arterial hypertension.
- FIGURE 3
Estimated life expectancy, quality-adjusted life-years (QALYs) and lifelong healthcare costs plotted against diagnostic delay of chronic thromboembolic pulmonary hypertension. LE: life expectancy.
- FIGURE 4
Tornado diagram showing the impact of maximal reduction of delay on a) costs, b) quality-adjusted life-years (QALYs) and c) costs-per-QALY, depending on model assumptions (compared to current delay). CTEPH: chronic thromboembolic pulmonary hypertension; PEA: pulmonary endarterectomy; BPA: balloon pulmonary angioplasty.
Tables
- TABLE 1
EuroQol five dimensions questionnaire (EQ-5D) utility values for each health state in the Markov model
Utilities PEA group BPA group PAH-targeted therapy group No-treatment group Pre-treatment 0.504 [23]# 0.504 [23]# 0.504 [23]# 0.504 [23]# Post-treatment 0.743 [23, 25]# 0.705 [25]# 0.73 [5] 0.504¶ PES: pulmonary endarterectemy; PAH: pulmonary arterial hypertension. #: after transforming the known utility values derived from the SF-36 questionnaire to estimated EuroQol five dimensions (EQ-5D) values following the method reported by Rowen et al. [25]. ¶: identical to pre-treatment utility in PEA group.
- TABLE 2
Estimated average lifelong healthcare costs (euros) and effectiveness
Base case (i.e. current care) No delay Difference Screening programme costs - 4125 - Hospital costs 21 493 27 472 5979 Medication costs (weighted per treatment group) PEA (60%) 40 297 55 094 14 797 BPA (15%) 27 636 37 619 9983 PAH-targeted therapy (15%) 27 679 37 449 9770 No treatment (5%) - - - Total lifelong costs 117 105 161 759 44 654 Life expectancy years 14.3 17.3 3.01 QALYs years 8.42 10.45 2.04 Incremental cost-effectiveness ratio 14 853 per life-year gained Incremental cost–utility ratio 21 910 per QALY gained PEA: pulmonary endarterectomy; BPA: balloon pulmonary angioplasty; PH: pulmonary hypertension; QALY: quality-adjusted life-year.
Supplementary Material
Please note: supplementary material is not edited by the Editorial Office, and is uploaded as it has been supplied by the author.
Supplementary material 00719-2020.SUPPLEMENT
Model 00719-2020.model
