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Cost-Utility Analysis of Specialized Multidisciplinary Care Versus Standard Care in the Management of Patients with Reduced Ejection Fraction Heart Failure in Thailand

Thitiya Khongmee¹, Artit Torpongpun², Supicha Intarachumnum³, Nattanichcha Kulthanachairojana⁴

Affiliation : ¹ Pharmacy Department, Chonburi Hospital, Chonburi, Thailand, ² Medicine Department, Chonburi Hospital, Chonburi, Thailand, ³ Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, Chonburi, Thailand, ⁴ Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, Chonburi, Thailand

Objective: To compare the cost-utility of specialized multidisciplinary care (MC) and standard care (SC) of patients with reduced ejection fraction heart failure (HFrEF).
Materials and Methods: The present study was a retrospective analytical cohort study on societal perspective in the 12-month follow-up of patients in the tertiary hospitals in Thailand. Conventional care was offered to the patients in the SC group by the hospitals, and the MC group received additional care in the specialized care of the multidisciplinary heart failure clinic. The authors collected data pertaining to resource utilization from the hospital medical records. The unit cost was based on the Thai Health Technology Assessment’s standard cost list. Quality-adjusted life years (QALYs) were the health outcome of the study.
Results: The total cost per patient in MC group was $835.24 versus $933.10 in the SC group. SC and MC QALYs were 0.72 and 0.78, respectively. MC is an outstanding alternative to save cost of $97.86 annually per patient. Patients in the MC group used fewer resources because the complication and hospitalization rates were lower.
Conclusion: MC appeared to be a cost-saving approach compared with ambulatory care delivery from SC to patients with HFrEF.

Received 27 September 2021 | Revised 4 June 2022 | Accepted 8 July 2022
DOI: 10.35755/jmedassocthai.2022.08.13442

Keywords : Cost-utility analysis; Reduced ejection fraction heart failure; Heart failure clinic; Multidisciplinary care


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