@article{DorenkampBonaventuraSohnsetal.2012,
  author    = {Dorenkamp, Marc and Bonaventura, Klaus and Sohns, Christian and Becker, Christoph R. and Leber, Alexander W.},
  title     = {Direct costs and cost-effectiveness of dual-source computed tomography and invasive coronary angiography in patients with an intermediate pretest likelihood for coronary artery disease},
  series = {Heart},
  volume    = {98},
  journal   = {Heart},
  number    = {6},
  publisher = {BMJ Publ. Group},
  address   = {London},
  issn      = {1355-6037},
  doi       = {10.1136/heartjnl-2011-300149},
  pages     = {460 -- 467},
  year      = {2012},
  abstract  = {Aims The study aims to determine the direct costs and comparative cost-effectiveness of latest-generation dual-source computed tomography (DSCT) and invasive coronary angiography for diagnosing coronary artery disease (CAD) in patients suspected of having this disease. Methods The study was based on a previously elaborated cohort with an intermediate pretest likelihood for CAD and on complementary clinical data. Cost calculations were based on a detailed analysis of direct costs, and generally accepted accounting principles were applied. Based on Bayes' theorem, a mathematical model was used to compare the cost-effectiveness of both diagnostic approaches. Total costs included direct costs, induced costs and costs of complications. Effectiveness was defined as the ability of a diagnostic test to accurately identify a patient with CAD. Results Direct costs amounted to (sic)98.60 for DSCT and to (sic)317.75 for invasive coronary angiography. Analysis of model calculations indicated that cost-effectiveness grew hyperbolically with increasing prevalence of CAD. Given the prevalence of CAD in the study cohort (24\%), DSCT was found to be more cost-effective than invasive coronary angiography ((sic)970 vs (sic)1354 for one patient correctly diagnosed as having CAD). At a disease prevalence of 49\%, DSCT and invasive angiography were equally effective with costs of (sic)633. Above a threshold value of disease prevalence of 55\%, proceeding directly to invasive coronary angiography was more cost-effective than DSCT. Conclusions With proper patient selection and consideration of disease prevalence, DSCT coronary angiography is cost-effective for diagnosing CAD in patients with an intermediate pretest likelihood for it. However, the range of eligible patients may be smaller than previously reported.},
  language  = {en}
}
@article{ChungVongpatanasinBonaventuraetal.2014,
  author    = {Chung, Oliver and Vongpatanasin, Wanpen and Bonaventura, Klaus and Lotan, Yair and Sohns, Christian and Haverkamp, Wilhelm and Dorenkamp, Marc},
  title     = {Potential cost-effectiveness of therapeutic drug monitoring in patients with resistant hypertension},
  series = {Journal of hypertension},
  volume    = {32},
  journal   = {Journal of hypertension},
  number    = {12},
  publisher = {Lippincott Williams \& Wilkins},
  address   = {Philadelphia},
  issn      = {0263-6352},
  doi       = {10.1097/HJH.0000000000000346},
  pages     = {2411 -- 2421},
  year      = {2014},
  abstract  = {Background: Nonadherence to drug therapy poses a significant problem in the treatment of patients with presumed resistant hypertension. It has been shown that therapeutic drug monitoring (TDM) is a useful tool for detecting nonadherence and identifying barriers to treatment adherence, leading to effective blood pressure (BP) control. However, the cost-effectiveness of TDM in the management of resistant hypertension has not been investigated. Results: In the age group of 60-year olds, TDM gained 1.07 QALYs in men and 0.97 QALYs in women at additional costs of (sic)3854 and (sic)3922, respectively. Given a willingness-to-pay threshold of (sic)35 000 per QALY gained, the probability of TDM being cost-effective was 95\% or more in all age groups from 30 to 90 years. Results were influenced mostly by the frequency of TDM testing, the rate of nonresponders to TDM, and the magnitude of effect of TDM on BP. Conclusion: Therapeutic drug monitoring presents a potential cost-effective healthcare intervention in patients diagnosed with resistant hypertension. Importantly, this finding is valid for a wide range of patients, independent of sex and age.},
  language  = {en}
}
@article{BonaventuraLeberSohnsetal.2012,
  author    = {Bonaventura, Klaus and Leber, Alexander W. and Sohns, Christian and Roser, Mattias and Boldt, Leif-Hendrik and Kleber, Franz X. and Haverkamp, Wilhelm and Dorenkamp, Marc},
  title     = {Cost-effectiveness of paclitaxel-coated balloon angioplasty and paclitaxel-eluting stent implantation for treatment of coronary in-stent restenosis in patients with stable coronary artery disease},
  series = {Clinical research in cardiology : official journal of the German Cardiac Society.},
  volume    = {101},
  journal   = {Clinical research in cardiology : official journal of the German Cardiac Society.},
  number    = {7},
  publisher = {Springer},
  address   = {Heidelberg},
  issn      = {1861-0684},
  doi       = {10.1007/s00392-012-0428-2},
  pages     = {573 -- 584},
  year      = {2012},
  abstract  = {Recent studies have demonstrated the safety and efficacy of drug-coated balloon (DCB) angioplasty for the treatment of coronary in-stent restenosis (ISR). The cost-effectiveness of this practice is unknown. A Markov state-transition decision analytic model accounting for varying procedural efficacy rates, complication rates, and cost estimates was developed to compare DCB angioplasty with drug-eluting stent (DES) placement in patients with bare-metal stent (BMS)-ISR. Data on procedural outcomes associated with both treatment strategies were derived from the literature, and the cost analysis was conducted from a health care payer perspective. Effectiveness was expressed as life-years gained. In the base-case analysis, initial procedure costs amounted to a,not sign3,604.14 for DCB angioplasty and to a,not sign3,309.66 for DES implantation. Over a 12-month time horizon, the DCB strategy was found to be less costly (a,not sign4,130.38 vs. a,not sign5,305.30) and slightly more effective in terms of life expectancy (0.983 vs. 0.976 years) than the DES strategy. Extensive sensitivity analyses indicated that, in comparison with DES implantation, the cost advantage of the DCB strategy was robust to clinically plausible variations in the values of key model input parameters. The variables with the greatest impact on base-case results were the duration of dual antiplatelet therapy with acetylsalicylic acid and clopidogrel after DCB angioplasty, the use of generic clopidogrel, and variations in the costs associated with the DCB device. DCB angioplasty is a cost-effective treatment option for coronary BMS-ISR. The higher initial costs of DCB are more than offset by later cost-savings, predominantly as a result of reduced medication costs.},
  language  = {en}
}
@article{BoldtLeberBonaventuraetal.2013,
  author    = {Boldt, Julia and Leber, Alexander W. and Bonaventura, Klaus and Sohns, Christian and Stula, Martin and Huppertz, Alexander and Haverkamp, Wilhelm and Dorenkamp, Marc},
  title     = {Cost-effectiveness of cardiovascular magnetic resonance and single-photon emission computed tomography for diagnosis of coronary artery disease in Germany},
  series = {Journal of cardiovascular magnetic resonance},
  volume    = {15},
  journal   = {Journal of cardiovascular magnetic resonance},
  number    = {30},
  publisher = {BioMed Central},
  address   = {London},
  issn      = {1097-6647},
  doi       = {10.1186/1532-429X-15-30},
  pages     = {11},
  year      = {2013},
  abstract  = {Background: Recent studies have demonstrated a superior diagnostic accuracy of cardiovascular magnetic resonance (CMR) for the detection of coronary artery disease (CAD). We aimed to determine the comparative cost-effectiveness of CMR versus single-photon emission computed tomography (SPECT). Methods: Based on Bayes' theorem, a mathematical model was developed to compare the cost-effectiveness and utility of CMR with SPECT in patients with suspected CAD. Invasive coronary angiography served as the standard of reference. Effectiveness was defined as the accurate detection of CAD, and utility as the number of quality-adjusted life-years (QALYs) gained. Model input parameters were derived from the literature, and the cost analysis was conducted from a German health care payer's perspective. Extensive sensitivity analyses were performed. Results: Reimbursement fees represented only a minor fraction of the total costs incurred by a diagnostic strategy. Increases in the prevalence of CAD were generally associated with improved cost-effectiveness and decreased costs per utility unit (Delta QALY). By comparison, CMR was consistently more cost-effective than SPECT, and showed lower costs per QALY gained. Given a CAD prevalence of 0.50, CMR was associated with total costs of (sic)6,120 for one patient correctly diagnosed as having CAD and with (sic)2,246 per Delta QALY gained versus (sic)7,065 and (sic)2,931 for SPECT, respectively. Above a threshold value of CAD prevalence of 0.60, proceeding directly to invasive angiography was the most cost-effective approach. Conclusions: In patients with low to intermediate CAD probabilities, CMR is more cost-effective than SPECT. Moreover, lower costs per utility unit indicate a superior clinical utility of CMR.},
  language  = {en}
}
@article{DorenkampBonaventuraLeberetal.2013,
  author    = {Dorenkamp, Marc and Bonaventura, Klaus and Leber, Alexander W. and Boldt, Julia and Sohns, Christian and Boldt, Leif-Hendrik and Haverkamp, Wilhelm and Frei, Ulrich and Roser, Mattias},
  title     = {Potential lifetime cost-effectiveness of catheter-based renal sympathetic denervation in patients with resistant hypertension},
  series = {European heart journal},
  volume    = {34},
  journal   = {European heart journal},
  number    = {6},
  publisher = {Oxford Univ. Press},
  address   = {Oxford},
  issn      = {0195-668X},
  doi       = {10.1093/eurheartj/ehs355},
  pages     = {451 -- +},
  year      = {2013},
  abstract  = {Aims Recent studies have demonstrated the safety and efficacy of catheter-based renal sympathetic denervation (RDN) for the treatment of resistant hypertension. We aimed to determine the cost-effectiveness of this approach separately for men and women of different ages. Methods and results A Markov state-transition model accounting for costs, life-years, quality-adjusted life-years (QALYs), and incremental cost-effectiveness was developed to compare RDN with best medical therapy (BMT) in patients with resistant hypertension. The model ran from age 30 to 100 years or death, with a cycle length of 1 year. The efficacy of RDN was modelled as a reduction in the risk of hypertension-related disease events and death. Analyses were conducted from a payer's perspective. Costs and QALYs were discounted at 3\% annually. Both deterministic and probabilistic sensitivity analyses were performed. When compared with BMT, RDN gained 0.98 QALYs in men and 0.88 QALYs in women 60 years of age at an additional cost of (sic)2589 and (sic)2044, respectively. As the incremental cost-effectiveness ratios increased with patient age, RDN consistently yielded more QALYs at lower costs in lower age groups. Considering a willingness-to-pay threshold of (sic)35 000/QALY, there was a 95\% probability that RDN would remain cost-effective up to an age of 78 and 76 years in men and women, respectively. Cost-effectiveness was influenced mostly by the magnitude of effect of RDN on systolic blood pressure, the rate of RDN non-responders, and the procedure costs of RDN. Conclusion Renal sympathetic denervation is a cost-effective intervention for patients with resistant hypertension. Earlier treatment produces better cost-effectiveness ratios.},
  language  = {en}
}
@article{DorenkampBoldtLeberetal.2013,
  author    = {Dorenkamp, Marc and Boldt, Julia and Leber, Alexander W. and Sohns, Christian and Roser, Mattias and Boldt, Leif-Hendrik and Haverkamp, Wilhelm and Bonaventura, Klaus},
  title     = {Cost-effectiveness of paclitaxel-coated balloon angioplasty in patients with drug-eluting stent restenosis},
  series = {Clinical cardiology : international journal for cardiovascular diseases},
  volume    = {36},
  journal   = {Clinical cardiology : international journal for cardiovascular diseases},
  number    = {7},
  publisher = {Wiley-Blackwell},
  address   = {Hoboken},
  issn      = {0160-9289},
  doi       = {10.1002/clc.22130},
  pages     = {407 -- 413},
  year      = {2013},
  abstract  = {BackgroundThe economic impact of drug-eluting stent (DES) in-stent restenosis (ISR) is substantial, highlighting the need for cost-effective treatment strategies. HypothesisCompared to plain old balloon angioplasty (POBA) or repeat DES implantation, drug-coated balloon (DCB) angioplasty is a cost-effective therapy for DES-ISR. MethodsA Markov state-transition model was used to compare DCB angioplasty with POBA and repeat DES implantation. Model input parameters were obtained from the literature, and the cost analysis was conducted from a German healthcare payer's perspective. Extensive sensitivity analyses were performed. ResultsInitial procedure costs amounted to Euro3488 for DCB angioplasty and to Euro2782 for POBA. Over a 6-month time horizon, the DCB strategy was less costly (Euro4028 vs Euro4169) and more effective in terms of life-years (LYs) gained (0.497 versus 0.489) than POBA. The DES strategy incurred initial costs of Euro3167 and resulted in 0.494 LYs gained, at total costs of Euro4101 after a 6-month follow-up. Thus, DCB angioplasty was the least costly and most effective strategy. Base-case results were influenced mostly by initial procedure costs, target lesion revascularization rates, and the costs of dual antiplatelet therapy. ConclusionsDCB angioplasty is a cost-effective treatment option for coronary DES-ISR. The higher initial costs of the DCB strategy compared to POBA or repeat DES implantation are offset by later cost savings.},
  language  = {en}
}
@misc{BoldtLeberBonaventuraetal.2013,
  author    = {Boldt, Julia and Leber, Alexander W. and Bonaventura, Klaus and Sohns, Christian and Stula, Martin and Huppertz, Alexander and Haverkamp, Wilhelm and Dorenkamp, Marc},
  title     = {Cost-effectiveness of cardiovascular magnetic resonance and single-photon emission computed tomography for diagnosis of coronary artery disease in Germany},
  series = {Postprints der Universit{\"a}t Potsdam Humanwissenschaftliche Reihe},
  journal   = {Postprints der Universit{\"a}t Potsdam Humanwissenschaftliche Reihe},
  number    = {551},
  issn      = {1866-8364},
  doi       = {10.25932/publishup-43010},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-430107},
  pages     = {11},
  year      = {2013},
  abstract  = {Background: Recent studies have demonstrated a superior diagnostic accuracy of cardiovascular magnetic resonance (CMR) for the detection of coronary artery disease (CAD). We aimed to determine the comparative cost-effectiveness of CMR versus single-photon emission computed tomography (SPECT). Methods: Based on Bayes' theorem, a mathematical model was developed to compare the cost-effectiveness and utility of CMR with SPECT in patients with suspected CAD. Invasive coronary angiography served as the standard of reference. Effectiveness was defined as the accurate detection of CAD, and utility as the number of quality-adjusted life-years (QALYs) gained. Model input parameters were derived from the literature, and the cost analysis was conducted from a German health care payer's perspective. Extensive sensitivity analyses were performed. Results: Reimbursement fees represented only a minor fraction of the total costs incurred by a diagnostic strategy. Increases in the prevalence of CAD were generally associated with improved cost-effectiveness and decreased costs per utility unit (Delta QALY). By comparison, CMR was consistently more cost-effective than SPECT, and showed lower costs per QALY gained. Given a CAD prevalence of 0.50, CMR was associated with total costs of (sic)6,120 for one patient correctly diagnosed as having CAD and with (sic)2,246 per Delta QALY gained versus (sic)7,065 and (sic)2,931 for SPECT, respectively. Above a threshold value of CAD prevalence of 0.60, proceeding directly to invasive angiography was the most cost-effective approach. Conclusions: In patients with low to intermediate CAD probabilities, CMR is more cost-effective than SPECT. Moreover, lower costs per utility unit indicate a superior clinical utility of CMR.},
  language  = {en}
}