{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:00:48Z","timestamp":1787068848821,"version":"build-2736575974"},"reference-count":26,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T00:00:00Z","timestamp":1733875200000},"content-version":"unspecified","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,11,15]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the cost-effectiveness of percutaneous repair (PR) for secondary mitral regurgitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>An economic evaluation using a time-varying Markov model comprising three states to assess the cost and effectiveness of PR added to guideline-directed medical treatment (GDMT) compared with GDMT alone. Clinical outcomes considered within the model were overall survival and heart failure (HF) hospitalisations (HFH), and the incremental cost-effectiveness ratio (ICER) was calculated. Cost data were derived from a literature search. Sensitivity analyses were undertaken.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The French healthcare system perspective assuming a lifetime horizon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Published data at 5 years obtained from patients enrolled in the Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In our base case, we chose cubic spline models to extrapolate overall survival, and we used log-logistic models to estimate cumulative HFH. After discounting, the model generated life-years of 3.843 years and 3.055 years for PR+GDMT\u2009and GDMT, respectively. Discounted total quality-adjusted life-year (QALY) values were 2.572 and 1.945 for PR+GDMT\u2009and GDMT, respectively (incremental 0.627 QALY). Discounted total costs were \u20ac42\u2009709 and \u20ac20\u2009732 for the intervention and the control groups, respectively (incremental \u20ac21,977), resulting in an ICER of \u20ac35,068\/QALY. At a threshold of \u20ac50\u2009000 per QALY, PR had a 0.85 probability of being cost-effective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Updated trial data have enabled investigators to provide a more reliable estimation of the ICER, which suggests that PR has good value for money compared with GDMT alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-087695","type":"journal-article","created":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T23:14:52Z","timestamp":1734045292000},"page":"e087695","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Cost-effectiveness of percutaneous mitral repair for patients with severe secondary mitral regurgitation: an updated evaluation using a modelling approach based on COAPT final data after 5-year follow-up"],"prefix":"10.1136","volume":"14","author":[{"given":"Martin","family":"Connock","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Auguste","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Fran\u00e7ois","family":"Obadia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1166-0453","authenticated-orcid":false,"given":"Xavier","family":"Armoiry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,12,11]]},"reference":[{"key":"2024121219543459000_14.12.e087695.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.10.018"},{"key":"2024121219543459000_14.12.e087695.2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2017-312605"},{"key":"2024121219543459000_14.12.e087695.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1806640"},{"key":"2024121219543459000_14.12.e087695.4","unstructured":"Transcatheter mitral valve repair (TMVR) market size by segments, share, regulatory, reimbursement, procedures and forecast to 2033. Available: https:\/\/www.globaldata.com\/store\/report\/transcatheter-mitral-valve-repair-devices-market-analysis\/ [Accessed 29 Feb 2024]."},{"key":"2024121219543459000_14.12.e087695.5","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0280554","article-title":"Impact of updated trial data on the cost-effectiveness of percutaneous mitral repair","volume":"18","author":"Connock","year":"2023","journal-title":"PLoS One"},{"key":"2024121219543459000_14.12.e087695.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2300213"},{"key":"2024121219543459000_14.12.e087695.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1805374"},{"key":"2024121219543459000_14.12.e087695.8","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1016\/j.jcmg.2020.07.021","article-title":"Impact of Mitral Regurgitation Severity and Left Ventricular Remodeling on Outcome After MitraClip Implantation: Results From the Mitra-FR Trial","volume":"14","author":"Messika-Zeitoun","year":"2021","journal-title":"JACC Cardiovasc Imaging"},{"key":"2024121219543459000_14.12.e087695.9","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0241361","article-title":"Conflicting findings between the Mitra-Fr and the Coapt trials: Implications regarding the cost-effectiveness of percutaneous repair for heart failure patients with severe secondary mitral regurgitation","volume":"15","author":"Armoiry","year":"2020","journal-title":"PLoS One"},{"key":"2024121219543459000_14.12.e087695.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.12.047"},{"key":"2024121219543459000_14.12.e087695.11","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2288-12-9","article-title":"Enhanced secondary analysis of survival data: reconstructing the data from published Kaplan-Meier survival curves","volume":"12","author":"Guyot","year":"2012","journal-title":"BMC Med Res Methodol"},{"key":"2024121219543459000_14.12.e087695.12","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.043275"},{"key":"2024121219543459000_14.12.e087695.13","doi-asserted-by":"crossref","first-page":"2035","DOI":"10.1016\/j.amjcard.2017.08.022","article-title":"Comparison of Outcome After Percutaneous Mitral Valve Repair With the MitraClip in Patients With Versus Without Atrial Fibrillation","volume":"120","author":"Velu","year":"2017","journal-title":"Am J Cardiol"},{"key":"2024121219543459000_14.12.e087695.14","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.jcin.2020.09.050","article-title":"COAPT-Like Profile Predicts Long-Term Outcomes in Patients With Secondary Mitral Regurgitation Undergoing MitraClip Implantation","volume":"14","author":"Adamo","year":"2021","journal-title":"JACC Cardiovasc Interv"},{"key":"2024121219543459000_14.12.e087695.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2021.11.1351"},{"key":"2024121219543459000_14.12.e087695.16","doi-asserted-by":"crossref","first-page":"ix","DOI":"10.3310\/hta8360","article-title":"Review of guidelines for good practice in decision-analytic modelling in health technology assessment","volume":"8","author":"Philips","year":"2004","journal-title":"Health Technol Assess"},{"key":"2024121219543459000_14.12.e087695.17","unstructured":"Haute Autorit\u00e9 de Sant\u00e9 . Guide M\u00e9thodologique: Choix m\u00e9thodologiques pour l\u2019\u00e9valuation de l\u2019efficience \u00e0 la HAS Version soumise \u00e0 la consultation publique. 2019."},{"key":"2024121219543459000_14.12.e087695.18","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1177\/1536867X1801800114","article-title":"Assessing the Health Economic Agreement of Different Data Sources","volume":"18","author":"Gallacher","year":"2018","journal-title":"Stata J Promoting comm on stats and Stata"},{"key":"2024121219543459000_14.12.e087695.19","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1177\/1536867X0400400302","article-title":"Graphing Confidence Ellipses: An Update of Ellip for Stata 8","volume":"4","author":"Alexandersson","year":"2004","journal-title":"Stata J Promoting comm on stats and Stata"},{"key":"2024121219543459000_14.12.e087695.20","doi-asserted-by":"publisher","DOI":"10.1080\/13696998.2020.1854769"},{"key":"2024121219543459000_14.12.e087695.21","unstructured":"National Guideline Centr (NICE) . Cost-utility analysis: transcatheter mitral edgeto-edge repair for inoperable patients. NICE guideline NG208. 2021."},{"key":"2024121219543459000_14.12.e087695.22","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1007\/s10198-022-01476-4","article-title":"Cost-effectiveness of the MitraClip device in German heart failure patients with secondary mitral regurgitation","volume":"24","author":"Estler","year":"2023","journal-title":"Eur J Health Econ"},{"key":"2024121219543459000_14.12.e087695.23","doi-asserted-by":"crossref","first-page":"2023","DOI":"10.1002\/ehf2.14729","article-title":"Long-term cost-effectiveness of transcatheter mitral valve repair in HF patients with secondary mitral regurgitation","volume":"11","author":"Yao","year":"2024","journal-title":"ESC Heart Fail"},{"key":"2024121219543459000_14.12.e087695.24","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2021-320005"},{"key":"2024121219543459000_14.12.e087695.25","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1056\/NEJMoa2314328","article-title":"Transcatheter Valve Repair in Heart Failure with Moderate to Severe Mitral Regurgitation","volume":"391","author":"Anker","year":"2024","journal-title":"N Engl J Med"},{"key":"2024121219543459000_14.12.e087695.26","unstructured":"Armoiry X , Connock M , Madani R , et al . Assessing long-term survival outcomes after percutaneous repair for patients with severe mitral regurgitation. PROSPERO 2023 CRD42023429527."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2024-087695","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T23:15:01Z","timestamp":1734045301000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2024-087695"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":26,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12,11]]},"published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1136\/bmjopen-2024-087695"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2024-087695","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12]]}}}