Author + information
- Marco Arena1,
- Roberto Gistri2,
- Giorgio Caretta1,
- Anees Al Jabri3,
- Giorgio Tonelli4 and
- Veronica Scardigli1
This work is aimed at estimating the economic impact of the routine use of Fractional Flow Reserve (FFR) versus lone angiography in all-comers patients (pts) referred for cardiac catheterization.
All pts who consecutively underwent FFR-guided revascularization (REV) were included in a 3 years registry. FFR evaluation was performed in lesions that were thought to require PCI or CABG on the basis of angiographic appearance. In order to evaluate the economic impact of FFR we compared costs incurred by pts who underwent FFR-guided REV (“FFR scenario”; FS) with the costs of hypothetical cohort of pts with the same characteristics but who underwent angio-guided REV (“angio scenario”; AS). In AS, PCI related costs were estimated using the average consumption observed in FFR-revascularized pts. The analysis included the DRGs for the adverse events (AE) observed during the follow-up. The rate of AE in AS was considered the same of that observed in pts who received FFR-guided REV.
Out of 403 pts, ACS was present in 267 pts; 136 pts had other clinical conditions. Median follow-up was 4 years. In the AS, 138 pts were estimated to receive PCI and 33 pts were considered eligible for CABG. Comparing AS vs FS scenario, the hospital saved €335K on consumables and days of hospitalization related to angio-guided PCI. In terms of DRGs, the payer saved € 903K (61%) for unnecessary REV (PCI €549K and CABG €354K). Overall costs saved, including follow-up analysis, was € 954K.
FFR can increase the appropriateness of REV allowing both providers and payers to save money in the short and in long term.
IMAGING: FFR and Physiologic Lesion Assessment