Device runtime and costs of cardiac resynchronization therapy pacemakers - a health claims data analysis
Moritz Hadwiger1, Nikolaos Dagres2, Gerhard Hindricks2
1Institute of Social Medicine and Epidemiology, University of Lübeck, Germany.
Insights
Biventricular defibrillators (CRT-D) have a shorter device runtime of about two years and higher costs compared to biventricular pacemakers (CRT-P). This analysis provides key data for cardiac resynchronization therapy device management.
Area of Science:
- Cardiology
- Health Economics
- Medical Device Technology
Background:
- Cardiac resynchronization therapy (CRT) devices, including biventricular defibrillators (CRT-D) and biventricular pacemakers (CRT-P), are crucial for heart failure management.
- Accurate data on the real-world device runtime and associated costs for all CRT device manufacturers are limited, particularly for CRT-P.
Purpose of the Study:
- To investigate and compare the device runtime and implantation costs of CRT-D versus CRT-P devices.
- To provide data for cost-effectiveness analyses of CRT devices.
Main Methods:
- Analysis of health claims data from a large German health insurance provider.
- Device runtime defined as the interval between implantation and generator change/removal.
- Median costs for implantation, change, and removal were calculated.
Main Results:
- The study analyzed 17,826 patients, with 4,296 CRT-D and 429 CRT-P complete runtimes.
- Median device runtime was 6.04 years for CRT-D and 8.16 years for CRT-P (p<0.0001).
- Median implantation costs were 14,270 EUR for CRT-D and 9,349 EUR for CRT-P.
Conclusions:
- CRT-D devices exhibit a significantly shorter median runtime (approximately 2 years less) than CRT-P devices.
- CRT-D devices are associated with substantially higher implantation costs.
- Findings offer valuable insights for optimizing CRT device selection and healthcare resource allocation.
Abstract:
Introduction: This study investigates the runtime and costs of biventricular defibrillators (CRT-D) and biventricular pacemakers (CRT-P). Accurate estimates of cardiac resynchronization therapy (CRT) device runtime across all manufactures are rare, especially for CRT-P. Methods: Health claims data of a large nationwide German health insurance was used to analyze CRT device runtime. We defined device runtime as the time between the date of implantation and the date of generator change or removal. The median costs for implantation, change, and removal of a CRT device were calculated accordingly. Results: In total, the data set comprises 17,826 patients. A total of 4,296 complete runtimes for CRT-D devices and 429 complete runtimes for CRT-P devices were observed. Median device runtime was 6.04 years for CRT-D devices and 8.16 years for CRT-P devices (log-rank test p<0.0001). The median cost of implantation for a CRT-D device was 14,270 EUR, and for a CRT-P device 9,349 EUR. Conclusions: Compared to CRT-P devices, CRT-D devices had a significantly shorter device runtime of about two years. Moreover, CRT-D devices were associated with higher cost. The study provides important findings that can be utilized by cost-effectiveness analyses.
