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Are implantable cardioverter- defibrillators cost-effective?
1Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Room 5342, Los Angeles, CA 90048, USA. c.peter@cshs.org
Current Cardiology Reports
|August 23, 2000
Summary
Implantable cardioverter-defibrillators (ICDs) offer survival benefits for sudden cardiac death survivors. The cost-effectiveness of ICDs compared to antiarrhythmic drugs is considered acceptable given the survival advantage.
Area of Science:
- Cardiology
- Medical Technology
- Health Economics
Background:
- Sudden cardiac death (SCD) is a major cause of cardiovascular mortality.
- Ventricular tachyarrhythmias are frequently implicated in SCD.
- Implantable cardioverter-defibrillators (ICDs) have demonstrated survival benefits in specific patient groups.
Purpose of the Study:
- To evaluate the cost-effectiveness of ICDs compared to antiarrhythmic drug therapy.
- To assess the incremental cost per life-year saved by ICDs in high-risk patients.
Main Methods:
- Analysis of data from randomized controlled trials comparing ICDs and antiarrhythmic drugs.
- Economic evaluation focusing on incremental costs and life-years gained.
Main Results:
- In patients with nonsustained ventricular tachycardia, low ejection fraction, and inducible sustained ventricular tachycardia unresponsive to procainamide, ICDs cost $27,000 per life-year saved compared to drug therapy.
- This cost is considered acceptable given the survival benefits.
Conclusions:
- ICD therapy provides a significant survival advantage in selected patients at risk for sudden cardiac death.
- The incremental cost of ICDs is a potentially acceptable investment for improving patient survival.
- Future technological advancements may further enhance the cost-effectiveness of ICDs.