PUK10 Cost–Utility Analysis of DyeVert Contrast Reduction Systems for Preventing Contrast-Induced Acute Kidney Injury in Patients Undergoing Coronary and/or Peripheral Angiography

Abstract

Contrast-induced acute kidney injury (CI-AKI) is a complication commonly associated with invasive arterial angiographic procedures and is among the leading causes of hospital-acquired acute kidney injury. CI-AKI is costly and associated with a higher morbidity and mortality. The DyeVert™ System is intended to reduce the overall volume of contrast media injected and potentially improve long-term health outcomes. A de novo decision analytic model was developed based on the current treatment pathway to estimate the costs and outcomes of using the DyeVert System in England. A meta-analysis was conducted to estimate the effectiveness of DyeVert System. Results from the meta-analysis and other clinical and economic inputs were extracted from local sources to inform the model. Costs were estimated from the National Health Service (NHS) and Personal Social Services perspective. Deterministic and probabilistic sensitivity analyses (PSA) were performed to explore the uncertainty surrounding the input parameters. Base-case results indicate that using DyeVert Systems as an adjunct to standard NHS clinical practice is less costly (£20,957 versus £19,865) and more effective (4.117 versus 4.158 quality-adjusted life years) than conventional hand or automated injection of contrast agent without using the DyeVert System. The sensitivity analysis results indicate that the cost saving per patient range from £141 to £1,092. Results from the PSA showed that the intervention has a high probability of being cost saving and cost effective (>99%). The cost savings are mainly driven by a lower risk of CI-AKI and associated subsequent complications. The introduction of the DyeVert System has the potential to reduce costs for the health care system and yield improved clinical outcomes for patients at risk of CI-AKI undergoing angiographic procedures.