Barostim therapy may be cost-effective for resistant hypertension


CVRx has announced that findings from a health-economic analysis, published in the Journal of Hypertension, indicate Barostim therapy is a cost-effective treatment option for patients with drug-resistant hypertension. The Barostim system is a programmable, minimally invasive device that consists of an implantable pulse generator (IPG), a 2mm electrode, and an external programmer.

A press release reports that, based on blood pressure reductions attained with Barostim therapy, the analysis projected that the therapy is associated with an anticipated incremental cost-effectiveness ratio (ICER) of €7,797 per quality adjusted life year (QALY) gained from a payer perspective in a European setting. It adds that this is significantly below the recognised European cost-effectiveness threshold of €35,000.

Barostim therapy is designed to trigger the natural blood pressure regulation system by electrically activating the carotid baroreceptors. Barostim neo is the second-generation system that is commercially available in Europe. The therapy is included in the joint European Society of Hypertension and European Society of Cardiology guidelines for the treatment of resistant hypertension.

The reduction in blood pressure with Barostim therapy was based on the double-blinded, randomised clinical trial published in the Journal of the American College of Cardiology and long-term follow-up data. The study analysed the impact of Barostim therapy on a cohort of drug-resistant hypertension patients with a systolic blood pressure >170mmHg. Patient characteristics were based on the actual patients treated with Barostim therapy in the randomised Barostim trial, as well as patient data from a large German epidemiological study.

The health economic model in this study uses risk equations and cost data from the published literature to project the economic and clinical impact of Barostim therapy for patients with drug-resistant hypertension. The model in the study is a combination of a decision tree and a Markov model, and it uses established multivariate risk equations from the Framingham heart study and the SCORE project to enable a robust projection of the impact of Barostim therapy on cardiovascular events and mortality.

The model shows that Barostim therapy may substantially reduce debilitating and costly cardiovascular events such as stroke, end stage renal disease, myocardial infarction, coronary heart disease and heart failure. Over a lifetime, Barostim is estimated to reduce the rate of stroke by 35%, end stage renal disease by 23%, myocardial infarction by 19%, and heart failure by 12%. Barostim was estimated to provide 1.66 additional life years and 2.17 additional quality-adjusted life years when compared with optimal medical management.

“This study provides an important perspective on the value of lowering the blood pressure for this group of drug resistant patients, clinically as well as from a health economic standpoint,” said Joachim Beige, study co-author, Head KfH Renal Unit / Department of Nephrology, Hospital St. Georg, Leipzig, Germany. “Moreover the estimated reductions in end-stage events such as stroke and end stage renal disease are substantial. This illustrates the impact which the blood pressure reduction of Barostim therapy can have.”