Table 2.
Main Inputs—Costs
| Parameter | Cost ($) | Source |
|---|---|---|
| LVAD implantation | 148,181 | * |
| LVAD monthly outpatient | 3,050 | 12 |
| MM monthly outpatient | 3,465 | 12 |
| Living with LVAD >10 years—annual | 19,887 | † |
| Living on MM > 10 years—annual | 9,744 | † |
| Heart transplantation | 148,181 | * |
| Living after HT—annual | 15,586 | ‡ |
| Stroke | ||
| First 90 days | 27,364 | ‡ |
| mRS 0—monthly | 936 | 23 |
| mRS 1—monthly | 964 | 23 |
| mRS 2—monthly | 1,115 | 23 |
| mRS 3—monthly | 1,915 | 23 |
| mRS 4—monthly | 3,876 | 23 |
| mRS 5—monthly | 5,698 | 23 |
| Pump exchange | 148,181 | * |
| Driveline infection | 13,416 | ‡ |
| GI bleed | 9,796 | ‡ |
| RHF | ||
| RVAD | 148,181 | * |
| no RVAD | 5,374 | ‡ |
| Other AEs | 9,041 | ‡ |
| MM readmission (apart from stroke) | 12,748 | 12 |
All costs were adjusted to reflect 2017 prices either on the IHD platform or using the medical care–specific CPI from the bureau of labor statistics.38
*CMS 2018 DRGs (i.e., 91.5% DRG 001 and 8.5% DRG 002).
†DRG 291 for cost estimation; event rate post 18-month resource use in Smedira.39
‡Medicare claims analysis.
LVAD, Left ventricular assist device; HT, heart transplantation; mRS, Modified Rankin Scale; GI, gastrointestinal; RHF, right heart failure; RVAD, right ventricular assist device; AE, adverse event; MM, medical management.