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Published on: February 28, 2012
Medical Cost Analysis of Implantable Cardioverter Defibrillators for Primary Prevention Among Cardiac Arrest Patients
Yusuke Kondo1, Toshinori Chiba2, Maiko Osawa3
1Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine.
Insights
Underuse of implantable cardioverter defibrillators (ICDs) for sudden cardiac death (SCD) prevention in Japan leads to significant medical costs. Providing guideline-directed ICD therapy could reduce mortality and healthcare spending.
Area of Science:
- Cardiology
- Health Economics
- Public Health Policy
Background:
- Implantable cardioverter defibrillators (ICDs) for primary prevention of sudden cardiac death (SCD) are underutilized in Japan due to lack of insurance reimbursement.
- This underuse has been linked to notable healthcare expenditures.
Purpose of the Study:
- To analyze the medical costs associated with the lack of primary prevention ICD therapy for SCD in Japan.
- To evaluate the economic impact of underutilization of ICDs.
Main Methods:
- A retrospective cohort study was conducted across 4 advanced critical care centers from January 2020 to December 2024.
- Data from 3,606 cardiac arrest cases were analyzed, identifying 348 patients with ICD-treatable rhythms.
- A subset of 43 patients (12.4%) eligible for ICD implantation prior to cardiac arrest was identified.
Main Results:
- The mean medical cost for patients eligible but not receiving ICD therapy was US $11,679 ± $14,666.
- These costs highlight the financial burden of SCD in patients who could have benefited from primary prevention ICDs.
Conclusions:
- A significant subset of patients eligible for primary prevention ICD therapy did not receive it before experiencing SCD.
- This underutilization is associated with substantial post-arrest medical costs.
- Implementing guideline-directed ICD therapy could reduce mortality and healthcare expenditure in Japan.
Background:
In Japan, the implantation of implantable cardioverter defibrillators (ICD) for the primary prevention of sudden cardiac death (SCD) is not covered by insurance reimbursement, and the underuse of ICDs has been noted. Therefore, this study analyzed the medical costs incurred due to a lack of primary prevention ICD therapy for SCD.
Methods And Results:
This retrospective cohort study analyzed data from 4 advanced critical care centers between January 2020 and December 2024. From a database of 3,606 cases of cardiac arrest, there were 348 patients with a documented rhythm at the time of arrest that could have been treated with an ICD. Of these patients, 43 (12.4%) had documented evidence of heart failure treatment and were eligible for ICD implantation before experiencing a cardiac arrest. The total mean (±SD) medical cost for these patients was US $11,679±14,666 (¥1,775,150±2,229,272).
Conclusions:
In this multicenter retrospective analysis, we identified a subset of patients who were eligible for primary prevention ICD therapy but did not receive it prior to experiencing sudden cardiac arrest. These cases were associated with substantial post-arrest medical costs. Our findings highlight the potential clinical and economic impact of the underutilization of ICDs in Japan and suggest that broader implementation of guideline-directed ICD therapy for primary prevention may reduce both mortality and healthcare expenditure.
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