COST-EFFECTIVENESSOF THE SYMPLICITY SPYRAL™ RENAL DENERVATION SYSTEM IN ADULTS WITH UNCONTROLLED HYPERTENSION IN TURKIYE
Author(s)
Anne M. Ryschon, MA1, Guvenc Kockaya, MSc, PhD, MD2, Mustafa KURNAZ, MSc3, Filiz Darici, MSc3, Ceren Ozturk, MSc4, Sinem ALTAN, MSc5, Funda Ozdiler, MSc4, Gorkey Turgut, MSc6, Gizem Varan, MSc4, Sinan Tektas, MSc4, Gorkem Basoglu, MSc4, Jan Benjamin Pietzsch, PhD1.
1Wing Tech Inc., Menlo Park, CA, USA, 2Econix Research, Tallin, Estonia, 3Econix Research, İstanbul, Turkey, 4Medtronic, İstanbul, Turkey, 5MEDTRONIC, ISTANBUL, Turkey, 6Medtronic Turkey, Istanbul, Turkey.
1Wing Tech Inc., Menlo Park, CA, USA, 2Econix Research, Tallin, Estonia, 3Econix Research, İstanbul, Turkey, 4Medtronic, İstanbul, Turkey, 5MEDTRONIC, ISTANBUL, Turkey, 6Medtronic Turkey, Istanbul, Turkey.
OBJECTIVES: Uncontrolled hypertension is associated with increased cardiovascular morbidity, mortality, and healthcare costs. Radiofrequency renal denervation (RF RDN) has emerged as a treatment option for patients whose blood pressure remains inadequately controlled despite conventional antihypertensive therapy. This study evaluated the cost-effectiveness of RF RDN compared to the standard of care (SOC) from the perspective of the Turkish Social Security Institution (SGK).
METHODS: A decision-analytic Markov model was utilized to project strategy-specific costs, quality-adjusted life years (QALYs), and clinical events over a lifetime horizon for RF RDN and SOC cohorts. Clinical effectiveness in the base case assumed an office-based systolic blood pressure(oSBP) reduction of -6.9 mmHg, based on a SPYRAL HTN-ON MED subgroup treated outside the US. Cost (2026 Turkish Lira(TRY)) and utility data were sourced from published literature, with 0% and 3% discounting of future costs and outcomes, respectively. The primary outcome was the incremental cost-effectiveness ratio(ICER), with cost-effectiveness evaluated based on a three-times GDP per capita threshold(TRY1,564,122). Extensive sensitivity analyses were performed.
RESULTS: In the base case, RF RDN resulted in increased costs of TRY266,112, +0.38 QALYs, which together led to a lifetime ICER of TRY705,051 per QALY gained. Among deterministic sensitivity analyses performed, cost-effectiveness was most impacted by the cost of RF RDN treatment, as well as the reduction in CHD and stroke resulting from lowered oSBP. RF RDN remained cost-effective, below a one- and three-time GDP per capital threshold, up to a device cost of TRY197,767 and TRY591,339, respectively. RF RDN remained cost-effective (below three-time GDP per capita threshold) across the range of scenarios explored.
CONCLUSIONS: Findings from this analysis suggest RF RDN to be a cost-effective treatment option in a Turkish healthcare setting, with a base case ICER significantly below the three-times GDP per capita threshold.
METHODS: A decision-analytic Markov model was utilized to project strategy-specific costs, quality-adjusted life years (QALYs), and clinical events over a lifetime horizon for RF RDN and SOC cohorts. Clinical effectiveness in the base case assumed an office-based systolic blood pressure(oSBP) reduction of -6.9 mmHg, based on a SPYRAL HTN-ON MED subgroup treated outside the US. Cost (2026 Turkish Lira(TRY)) and utility data were sourced from published literature, with 0% and 3% discounting of future costs and outcomes, respectively. The primary outcome was the incremental cost-effectiveness ratio(ICER), with cost-effectiveness evaluated based on a three-times GDP per capita threshold(TRY1,564,122). Extensive sensitivity analyses were performed.
RESULTS: In the base case, RF RDN resulted in increased costs of TRY266,112, +0.38 QALYs, which together led to a lifetime ICER of TRY705,051 per QALY gained. Among deterministic sensitivity analyses performed, cost-effectiveness was most impacted by the cost of RF RDN treatment, as well as the reduction in CHD and stroke resulting from lowered oSBP. RF RDN remained cost-effective, below a one- and three-time GDP per capital threshold, up to a device cost of TRY197,767 and TRY591,339, respectively. RF RDN remained cost-effective (below three-time GDP per capita threshold) across the range of scenarios explored.
CONCLUSIONS: Findings from this analysis suggest RF RDN to be a cost-effective treatment option in a Turkish healthcare setting, with a base case ICER significantly below the three-times GDP per capita threshold.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE461
Topic
Economic Evaluation
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)