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Single-chamber pacemakers: with or without leads? Cost-effectiveness and cost-utility analyses
José Ramón Lago-Quinteiro1, Francisco Reyes-Santias2, Manel Antelo3
1Servicio de Cardiologia, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain.
Annals of Medicine
|May 29, 2025
Summary
Leadless pacemakers offer superior cost-effectiveness and cost-utility compared to conventional pacemakers, with fewer complications. Despite a higher initial cost, leadless devices prove more economical in most cases.
Area of Science:
- Cardiology
- Medical Device Technology
- Health Economics
Background:
- Pacemaker technology has advanced in size, weight, functionality, and durability.
- The fundamental structure of battery and electrode-based pacemakers has remained consistent.
Purpose of the Study:
- To compare the cost-effectiveness and cost-utility of conventional pacemakers versus leadless pacemakers.
- To evaluate the economic benefits of emerging leadless pacemaker technology.
Main Methods:
- A retrospective observational study was conducted.
- 403 patients were randomly implanted with either a conventional or leadless pacemaker between June 2015 and January 2020.
- Data was collected from the Hospital-University Complex of Santiago de Compostela.
Main Results:
- Leadless pacemakers were implanted in 159 patients, and conventional pacemakers in 244 patients.
- Leadless pacemakers demonstrated superior cost-effectiveness and cost-utility.
- Incremental cost-effectiveness ratios were €6,263.38 per gained life year and €5,210.71 per quality-adjusted life year.
Conclusions:
- Leadless pacemakers are associated with fewer complications than conventional pacemakers.
- Although leadless pacemaker devices are more expensive initially, they are more cost-effective in approximately 90% of cases.
- Leadless pacemakers represent a more favorable economic option in the long term.
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