Patent foramen ovale closure cost-effective over long term

(HealthDay)—For patients with patent foramen ovale (PFO) and cryptogenic stroke, PFO closure is associated with higher costs but seems to be cost-effective over the long term when modeling medical treatment costs, according to research published in the Nov. 15 issue of The American Journal of Cardiology.

Christopher A. Pickett, M.D., from Johns Hopkins Hospital in Baltimore, and colleagues examined the cost-effectiveness of PFO closure using pooled weighted outcome and complication rates from published randomized controlled trials, Medicare cost tables, and wholesale medication prices. The authors calculated the incremental cost per life-year gained and per quality-adjusted life-year gained by PFO closure. They used the commonly accepted cost-effectiveness threshold of <$50,000/quality-adjusted life-year gained.

The researchers found that PFO closure was more costly at 2.6 years (mean duration of randomized controlled trial follow-up) per patient ($16,213), with a cost of $103,607 per life-year gained. The cost was $1.09 million to prevent one combined end point (transient ischemic attack, stroke, and death) at 2.6 years. PFO closure reached cost-effectiveness at 2.6 years with modeling the costs of medical treatment prospectively. The per-patient mean cost of medical therapy exceeded that of PFO closure at 30.2 years.

"In conclusion, PFO closure is associated with higher expenditures related to procedural costs; however, this increase may be offset over time by reduced event rates and costs of long-term medical treatment in patients who undergo transcatheter PFO closure," the authors write.

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