OBJECTIVES: The aim of this study is to estimate the health and economic impact of the reduction in mortality and the frequency of cardiovascular hospitalization, as a result of the diagnosis of cardiac transthyretin amyloidosis (ATTR-CM).

METHODS: Probabilistic Markov model, with time horizons between 1 and 15 years. An analysis of costs and effects was performed, comparing the correct diagnosis of ATTR-CM versus the non-diagnosis. Transition probabilities were obtained from the ATTR-ACT study (placebo arm) and from the literature. The costs (diagnosis, hospitalization for cardiovascular causes, heart failure treatment according to guidelines with or without diagnosis) were obtained from Spanish sources (€ 2019). The use of healthcare resources (National Health System perspective) and other model assumptions were obtained from a panel of Spanish clinical experts.

RESULTS: After 1, 5, 10 and 15 years, the diagnosis of ATTR-CM would generate a gain of 0.031 (95%CI 0.025; 0.038); 0.387 (95%CI 0.329; 0.435); 0.754 (95%CI 0.678; 0.781) and 0.944 (95%CI 0.905; 0.983) years of life per patient, respectively, with savings of € 212 (95%CI € -632; 633), € 2,289 (95%CI € 2,250; 2,517), € 2,859 (95%CI € 2,584; 3,149) and € 2,906 (95%CI € 2,669; 3,450) per patient, respectively, compared to the non-diagnosis of the disease. In the first year of follow-up, 10.1% fewer cardiovascular hospitalizations would be observed, among the group of patients diagnosed vs. the undiagnosed.

CONCLUSIONS: According to this model, with the correct diagnosis of ATTR-CM, years of life would be gained, hospitalizations due to cardiovascular causes would be avoided and savings would be generated for the Spanish NHS, compared to the non-diagnosis of the disease without considering initiation of specific therapies.