Renal denervation appears cost-effective for treatment-resistant hypertension

Results of a new health-economic analysis suggest that the Symplicity renal denervation system is a cost-effective strategy for patients with treatment-resistant hypertension.

The analysis revealed that the discounted incremental cost-effectiveness ratio of renal denervation with the Symplicity system is $3,071 per quality-adjusted life year (QALY), below the recognized threshold of $50,000 per QALY.

“The model used for the analysis projected that renal denervation could reduce the risk for stroke by 30% over 10 years, risk for MI by 32% over 10 years and CV mortality by 30% over 10 years, as compared with standard of care,” Jan B. Pietzsch, PhD, study director, president and CEO of Wing Tech Inc., told Cardiology Today.

Additionally, the model predicted substantial reductions in 10-year and lifetime probabilities of all-cause mortality, stroke, MI, CHD, HF and end-stage renal disease.

In other results, the model also revealed that the median survival rates were estimated at 18.4 years for renal denervation vs. 17.1 years for standard of care, and that CV endpoints might decrease by 21% to 32% over 10 years.

“[Renal denervation] is a therapy that can treat a chronic condition. To date, there are about 3 years of clinical follow-up that measured BP reduction with renal denervation. With this paper, we project what the effect of this BP reduction would be in terms of clinical outcome that can be expected over the lifetime of these patients. We are, for the first time, projecting the likely long-term effect of this therapy,” Pietzsch said in an interview.

The Markov model used for this analysis was designed by Wing Tech Inc. and was based on risk equations and cost data from the published literature to project the economic and clinical impact of renal denervation with the Symplicity system on patients with treatment-resistant hypertension. Treatment was defined as standard of care plus catheter-based renal denervation and other baseline patient characteristics were based on results of the Symplicity HTN-2 trial published in The Lancet in 2010.

“This health-economic model indicates that renal denervation … would offer a major advancement in our approach to addressing this growing and costly disease,” researcher Brent Egan, MD, professor in the department of medicine at Medical University of Southern California, said in a press release.

The Symplicity renal denervation system is investigational in the United States and is not currently approved by the FDA.

For more information:

Geisler BP. J Am Coll Cardiol. 2012;60:1271-1277.

Disclosure: Egan is a board member of Power Over Pressure, which received funding from Medtronic. Pietzsch has received travel support from the British Hypertension Society. Wing Tech Inc. (including Pietzsch) provided consulting services for Medtronic Ardian LLC to construct the health-economic model.