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. 2024 Dec 7;7(1):31-36.
doi: 10.1253/circrep.CR-24-0088. eCollection 2025 Jan 10.

Cost-Effectiveness of the Self-Care Management System for Heart Failure

Eisaku Nakane  1 , Takao Kato  2 , Nozomi Tanaka  2 , Makoto Idouji  1 , Yuki Yamamoto  1 , Wataru Saitou  1 , Toka Hamaguchi  1 , Mariko Yano  1 , Takeshi Harita  1 , Yuhei Yamaji  1 , Hiroki Fukuda  1 , Tetsuya Haruna  1 , Moriaki Inoko  1
Affiliations

Cost-Effectiveness of the Self-Care Management System for Heart Failure

Eisaku Nakane et al. Circ Rep. .

Abstract

Background: We recently reported that the self-care management system for heart failure (HF) decreased re-hospitalization for HF. In the present study we estimate the cost-effectiveness of this system.

Methods and results: We retrospectively enrolled 569 consecutive patients who were admitted for HF treatment at Kitano Hospital. In the present analysis, we sought to compare cardiovascular healthcare costs and the incremental cost-effective ratio (ICER), expressed as the cost per quality-adjusted life-years (QALY) gained, between patients using the self-care management system (n=153) and those not using the system (n=153) after propensity-score matching. To calculate the QALY, we used the New York Heart Association class and the corresponding scores of quality of life in every 3 months. The healthcare costs of cardiovascular disease were ¥129,747,016 in the user group and ¥156,427,032 in the non-user group, where 24 and 43 patients were hospitalized, respectively. The cost of this new system was ¥50,000 in the user group. The total costs were ¥129,797,016 in the user group and ¥156,427,032 in the non-user group. By using the system, the QALY increased from 0.653 to 0.686. The ICER was below 0 and the system was interpreted as cost-effective.

Conclusions: Use of the self-care management system is likely to be a cost-effective treatment for HF with the increase in QALY and the decrease in healthcare costs.

Keywords: Cost-effectiveness; Heart failure; Rehospitalization; Self-care management.

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Conflict of interest statement

E.N., M. Inoko, H.F., M.Y., Y. Yamaji, and T. Hamaguchi received a research grant from Bayer Yakuhin, Ltd, Takeda Pharmaceutical CO., Ltd, Novartis Pharma K.K., and IQVIA Services Japan G.K., and a scholarship grant from IQVIA Services Japan G.K., and Research Institute of Production Development. The other authors have no conflicts of interest.

Figures

Figure 1.
Figure 1.
Flowchart of patient selection.
Figure 2.
Figure 2.
(A) Kaplan-Meier curves of the survival rate in the user and non-user groups. (B) Kaplan-Meier curves of the event-free rate for heart failure hospitalization in the user and non-user groups.
Figure 3.
Figure 3.
Quality-adjusted life-years (QALY) in each quarter in users of the self-care management system. The 1-year survival curve was divided into 3-month intervals and the bars were approximated using the survival rates at each of 60, 90, 180, and 365 days. The New York Heart Association (NYHA) class and the corresponding scores for quality of life in each 3 months were then determined as follows: 0.82 in NYHA class 1; 0.78 in NYHA class 2; 0.65 in NYHA class 3; 0.58 in NYHA class 4; and 0 in death. QALY was calculated in each 3 months as a utility value times 0.25 as the number of years (3 months/1 year) and summed up around 1 year.
Figure 4.
Figure 4.
Quality-adjusted life-years (QALY) in each quarter in non-users of the self-care management system.
See this image and copyright information in PMC

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