Study Finds pVADs are Cost-Effective for High-Risk PCI
In the era of increasing healthcare costs, the cost-effectiveness of traditional versus emerging technologies is an ongoing consideration when evaluating long-term outcomes. A meta-analysis derived from six studies (Maini et al. 2014) determined that percutaneous ventricular assist devices (pVADs), particularly the Impella 2.5™ heart pump, were cost effective in the setting of high-risk PCI, when compared to the IABP. “The incremental cost-effectiveness ratio of Impella 2.5 was below the standard willingness-to-pay threshold.”
Of the studies reviewed, Gregory et al. 2013 and Roos et al. 2013 assessed the economic benefit of the Impella 2.5 alone in high-risk PCI patients, as shown below:
Studies Evaluating the Cost Effectiveness of the Impella 2.5 device for High-Risk PCI*
| Study and Study Design | Comparators | Age (years) | Gender (% male) | Results and Conclusions |
| Gregory et al. 2013
Retrospective cost analysis plus cost utility analysis | Impella 2.5 --n=216
IABP --n=211 | 67
68 | 82
80.6 | pVAD reduced major adverse events, readmission length of stay and readmission cost over 90-days
Cost effective long term |
| Roos et al. 2013
Cost utility analysis | IABP
Impella 2.5 --USpella n=175 --Europella n=144
ECMO | NR**
70
72
NR | NR
70
81
NR | pVAD cost effective for high risk PCI compared to IABP |
* Table adapted from Tables 1 and 2, Maini et al. 2014.
**NR=not reported
The authors concluded the cost reductions associated with the Impella 2.5 makes it “a high-value technology.”
To Learn More:
- Read the original article by Maini et al. 2014
- Read the original article by Gregory et al. 2013
- Read the original article by Roos et al. 2013
- Learn more about the use of Impella 2.5 for PCI
About Impella
The Impella 2.5 system is a temporary (<6 hours) ventricular support device indicated for use during high risk percutaneous coronary interventions (PCI) performed in elective or urgent, hemodynamically stable patients with severe coronary artery disease and depressed left ventricular ejection fraction, when a heart team, including a cardiac surgeon, has determined high risk PCI is the appropriate therapeutic option. Use of the Impella 2.5 in these patients may prevent hemodynamic instability which can result from repeat episodes of reversible myocardial ischemia that occur during planned temporary coronary occlusions and may reduce peri- and post-procedural adverse events.
Protected PCI and use of the Impella 2.5 is not right for every patient. Patients may not be able to be treated with Impella if they have certain pre-existing conditions, which a cardiologist can determine, such as: severe narrowing of the heart valve, severe peripheral artery disease, clots in blood vessels, or a replacement heart valve or certain heart valve deficiencies. Additionally, use of Impella has been associated with risks, including, but not limited to valvular and vascular injury, bleeding, and limb ischemia in certain patients. Learn more about the Impella devices’ approved indications for use, as well as important safety and risk information at www.protectedpci.com/hcp/information/isi.
