COST-EFFECTIVENESS ANALYSIS OF SPHERE-9 CATHETER IN PATIENTS WITH ATRIAL TACHYARRHYTHMIA IN TURKIYE
Author(s)
Rowan Iskandar, MSc1, Eleni Ismyrloglou, MSc2, waruiru mburu, MSc3, Guvenc Kockaya, MSc, PhD, MD4, Mustafa KURNAZ, MSc5, Filiz Darici, MSc6, Ceren Ozturk, MSc7, Sinem ALTAN, MSc8, Funda Ozdiler, MSc7, Gorkey Turgut, MSc9, Sezgi Aydan Ozet, MSc7, Mustafa Agaoglu, MSc7, Muhammet Arslan, MSc7.
1Medtronic International Trading Sàrl, Tolochenaz, Switzerland, 2Medtronic Bakken Research Center BV, Maastricht, Netherlands, 3Medtronic, Minneapolis, Minnesota, MN, USA, 4Econix Research, Tallin, Estonia, 5Econix Research, İstanbul, Turkey, 6Econix Research, Samsun, Turkey, 7Medtronic, İstanbul, Turkey, 8MEDTRONIC, ISTANBUL, Turkey, 9Medtronic Turkey, Istanbul, Turkey.
1Medtronic International Trading Sàrl, Tolochenaz, Switzerland, 2Medtronic Bakken Research Center BV, Maastricht, Netherlands, 3Medtronic, Minneapolis, Minnesota, MN, USA, 4Econix Research, Tallin, Estonia, 5Econix Research, İstanbul, Turkey, 6Econix Research, Samsun, Turkey, 7Medtronic, İstanbul, Turkey, 8MEDTRONIC, ISTANBUL, Turkey, 9Medtronic Turkey, Istanbul, Turkey.
OBJECTIVES: Atrial fibrillation (AF) is associated with stroke, heart failure, impaired quality of life, cognitive decline, and increased healthcare costs. Catheter ablation is an important rhythm-control strategy. This study evaluated the clinical and economic outcomes of dual-energy ablation with the Sphere-9™ Catheter compared with conventional contact-force radiofrequency (CFRF) ablation in adult patients with persistent AF from the Social Security Institution (SGK) perspective.
METHODS: A cost-effectiveness analysis was conducted from the SGK reimbursement perspective over a 40-year time horizon. A cohort of 20,000 patients with persistent AF was modeled using a hybrid structure consisting of a 1-year decision tree followed by a Markov model with three-month cycles. Key outcomes included AF recurrence, stroke, heart failure, repeat ablation, and mortality. Clinical inputs were derived from the SPHERE Per-AF randomized controlled trial (NCT05120193) and published literature. Device costs were based on the Health Implementation Communiqué (SUT), and drug costs were obtained from the Econalix Drug Tracking Application. Costs and outcomes were discounted at 3% annually. Uncertainty was assessed using probabilistic sensitivity analysis (PSA).
RESULTS: Total cost per patient was TRY 354,025 for CFRF ablation and TRY 311,128 for the Sphere-9™ Catheter. Quality-adjusted life years (QALYs) were 9.16 and 9.18, respectively. Compared with CFRF ablation, Sphere-9™ generated savings of TRY 42,898 per patient and provided an additional 0.02 QALYs, indicating dominance in the base-case analysis. PSA showed Sphere-9™ was dominant in 56% of simulations and cost-effective in 82% at a TRY 712,200 willingness-to-pay threshold.
CONCLUSIONS: The Sphere-9™ Catheter is a dominant, value-generating technology that improves patient health outcomes while delivering substantial cost savings compared to CFRF ablation. Integrating this system into the SGK reimbursement scheme is highly recommended to optimize healthcare resource allocation and elevate the standard of care for persistent AF patients in Türkiye.
METHODS: A cost-effectiveness analysis was conducted from the SGK reimbursement perspective over a 40-year time horizon. A cohort of 20,000 patients with persistent AF was modeled using a hybrid structure consisting of a 1-year decision tree followed by a Markov model with three-month cycles. Key outcomes included AF recurrence, stroke, heart failure, repeat ablation, and mortality. Clinical inputs were derived from the SPHERE Per-AF randomized controlled trial (NCT05120193) and published literature. Device costs were based on the Health Implementation Communiqué (SUT), and drug costs were obtained from the Econalix Drug Tracking Application. Costs and outcomes were discounted at 3% annually. Uncertainty was assessed using probabilistic sensitivity analysis (PSA).
RESULTS: Total cost per patient was TRY 354,025 for CFRF ablation and TRY 311,128 for the Sphere-9™ Catheter. Quality-adjusted life years (QALYs) were 9.16 and 9.18, respectively. Compared with CFRF ablation, Sphere-9™ generated savings of TRY 42,898 per patient and provided an additional 0.02 QALYs, indicating dominance in the base-case analysis. PSA showed Sphere-9™ was dominant in 56% of simulations and cost-effective in 82% at a TRY 712,200 willingness-to-pay threshold.
CONCLUSIONS: The Sphere-9™ Catheter is a dominant, value-generating technology that improves patient health outcomes while delivering substantial cost savings compared to CFRF ablation. Integrating this system into the SGK reimbursement scheme is highly recommended to optimize healthcare resource allocation and elevate the standard of care for persistent AF patients in Türkiye.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE158
Topic
Economic Evaluation
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)