The cost-effectiveness of primary prophylactic implantable defibrillator therapy in patients with ischaemic or non-ischaemic heart disease: a European analysis

European Heart Journal
Tim SmithM G Myriam Hunink

Abstract

It remains unclear whether primary prophylactic implantable cardioverter-defibrillator (ICD) therapy is cost-effective compared with a 'no ICD strategy' in the European health care setting. We performed a cost-effectiveness analysis for a cohort of patients with a left ventricular ejection fraction <40% and ischaemic or non-ischaemic heart disease. A Markov decision analytic model was used to evaluate long-term survival, quality-adjusted life years (QALYs), and lifetime costs for a cohort of patients with a reduced left ventricular function without previous arrhythmias, managed with a prophylactic ICD. Input data on effectiveness were derived from a meta-analysis of primary prophylactic ICD-only therapy randomized trials, from a prospective cohort study of ICD patients, from a health care utilization survey, and from the literature. Input data on costs were derived from a micro-cost analysis. Data on quality-of-life were derived from the literature. Deterministic and probabilistic sensitivity analysis was performed to assess the uncertainty. Probabilistic sensitivity analysis demonstrated a mean lifetime cost of €50 685 ± €4604 and 6.26 ± 0.64 QALYs for patients in the 'no ICD strategy'. Patients in the 'ICD strategy' accumulat...Continue Reading

References

Mar 22, 2001·The New England Journal of Medicine·S CazeauUNKNOWN Multisite Stimulation in Cardiomyopathies (MUSTIC) Study Investigators
Mar 22, 2002·The New England Journal of Medicine·Arthur J MossUNKNOWN Multicenter Automatic Defibrillator Implantation Trial II Investigators
May 21, 2004·The New England Journal of Medicine·Michael R BristowUNKNOWN Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION) Investigators
Jan 22, 2005·The New England Journal of Medicine·Gust H BardyUNKNOWN Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Investigators
Oct 7, 2005·The New England Journal of Medicine·Gillian D SandersDouglas K Owens
Aug 5, 2006·European Heart Journal·John CammSeah Nisam
Jun 30, 2007·Journal of the American College of Cardiology·Douglas S LeeAndreas Laupacis
Aug 25, 2007·European Journal of Heart Failure·Willem J RemmeKarl Swedberg
Jan 22, 2008·Journal of the American College of Cardiology·Ilan GoldenbergUNKNOWN MADIT-II Investigators
Mar 15, 2008·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·S S TanL Hakkaart-van Roijen
Sep 23, 2008·Journal of the American College of Cardiology·Roderick TungMark E Josephson
Jan 22, 2009·European Heart Journal·Heikki V HuikuriUNKNOWN Cardiac Arrhythmias and Risk Stratification after Acute Myocardial Infarction study group
Feb 7, 2009·Journal of the American College of Cardiology·Otto CostantiniUNKNOWN ABCD Trial Investigators
Mar 28, 2009·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Iwona CygankiewiczUNKNOWN MADIT II Investigators
Mar 28, 2009·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·H H F RemmeltsP M Ellerbroek
Apr 11, 2009·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Martin R CowieGiuseppe Boriani
May 28, 2009·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Mathias MeineRichard N W Hauer
Sep 3, 2009·The New England Journal of Medicine·Arthur J MossUNKNOWN MADIT-CRT Trial Investigators
Oct 3, 2009·Pacing and Clinical Electrophysiology : PACE·Paul KnopsLuc Jordaens
Oct 13, 2009·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Hans Van Brabandt, Mattias Neyt
Mar 2, 2010·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Bas Groot KoerkampM G Myriam Hunink
Oct 27, 2010·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Dominic A M J TheunsLuc Jordaens
Jul 21, 2011·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·T SmithL Jordaens

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Citations

Apr 10, 2013·Health Economics Review·Ralf BirkemeyerSteffen Wahler
Nov 19, 2013·Applied Health Economics and Health Policy·Fotini GialamaNikos Maniadakis
Apr 11, 2013·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·L R A Olde NordkampJ R de Groot
Apr 11, 2013·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·S C WijersM Meine
Oct 18, 2014·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Lidia García-PérezIñaki Imaz-Iglesia
Feb 5, 2015·Revista Española De Cardiología·Josep Comín-ColetPiotr Ponikowski
Sep 1, 2015·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Silvia G PrioriUNKNOWN Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the Eur
Sep 12, 2014·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·J SjöblomR Borgquist
Sep 8, 2016·BMC Health Services Research·Abraham Samuel BabuUNKNOWN in conjunction with the International Council of Cardiovascular Prevention and Rehabilitation (ICCPR)
May 11, 2017·Neuropsychological Rehabilitation·Samira Kashinath DhamapurkarGerhard Florschutz
Jun 3, 2017·European Journal of Preventive Cardiology·Gonzalo GrazioliMarta Sitges
Feb 1, 2017·Health Economics·Rosanna TarriconeValentina Prevolnik Rupel
Apr 8, 2017·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Amit KauraPaul Scott
Aug 30, 2014·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·M P VerhagenV A Umans
Dec 15, 2015·American Journal of Therapeutics·André Miguel Ramos Travessa, Luiz Filipe de Menezes Falcão
Dec 28, 2019·Pediatric Transplantation·Nadim H NasserNadir N Nasir
Aug 9, 2017·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·M van BarreveldUNKNOWN DO-IT investigators
Sep 4, 2013·Pacing and Clinical Electrophysiology : PACE·Joep ThijssenMartin J Schalij
Apr 24, 2013·Nature Reviews. Cardiology·Luis E RohdeCarísi A Polanczyk
Aug 15, 2020·Cancer radiothérapie : journal de la Société française de radiothérapie oncologique·R JumeauV Ferchaud
Aug 14, 2021·Journal of the American Heart Association·Shaan KhurshidSteven A Lubitz

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