Main Organiser

Julius Centre University of Malaya

Co-organiser

Department of Social and Preventive Medicine, Faculty of Medicine, University of Malay

Supported by

University of Malaya

ECONOMIC EVALUATION OF SURGICAL TREATMENTS IN SOUTH-ASIAN PATIENTS WITH RHEUMATIC HEART DISEASE

Author

Kataria A., Takyar S., Kumar P., Taneja A.

Institution

HERON Health Pvt. Ltd.

Abstract

Objectives: To collate the published economic evidence evaluating surgical treatment of rheumatic heart disease (RHD) in South Asia.

Methods: Embase® and MEDLINE® were searched to identify economic studies in English evaluating surgical treatment of RHD in South Asia. The searches were focussed on the evidence published in the past two decades (1990 to present).

Results: Five of the 52 citations met the pre- defined inclusion criteria. Among these, two were cost-analyses, two were cost-effectiveness analyses, and one was a resource use study. All studies (four in India and one in Pakistan) evaluated different techniques of treating rheumatic mitral stenosis. In Pakistan, closed mitral commissurotomy (CMV) was a cost-effective procedure compared to percutaneous transmitral commissurotomy (PTMC). In India, PTMC using double lumen balloons ($214) was more cost- effective than triple lumen balloons ($395) due to the reutilisation of catheters (6.3 ± 1.4 usages vs. 5.2 ± 0.8 usages). Further, balloon mitral valvuloplasty demonstrated significantly shorter hospital stay (3 days) compared to CMV (7 days; p>0.05).

Conclusion: Limited evidence precludes a definitive conclusion on superiority of CMV over PTMC in patients with RHD. However, existing evidence suggests that PTMC is associated with lower procedural costs due to reutilisation of catheters and shorter hospital stay.