AI Article Synopsis
Article Abstract
Aim: The aim of the study was to assess the incremental cost-effectiveness ratio (ICER) of Cardiac Resynchronization Therapy in combination with an Implantable Cardioverter Defibrillator (CRT-D) plus Optimal Pharmacological Therapy (OPT) compared to OPT alone in patients with chronic heart failure.
Methods And Results: A decision analytic model was used to estimate the ICER from a German Health Care System perspective. Effectiveness data were used as reported in the COMPANION study. Direct medical costs were considered for inpatient and outpatient treatments. Resource utilization was valued by the prices charged in 2005. Costs and effects were discounted by a discount rate of 3% per year. One-way and two-way sensitivity analyses were performed. The base-case analysis resulted in accumulated discounted QALYs of 0.958 for OPT, respectively 1.261 for CRT-D + OPT. Accumulated discounted costs were 4618 Euro for OPT, and 31 292 Euro for CRT-D + OPT, respectively, thus resulting in incremental costs per QALY gained of 88 143 Euro after two years. Considering a device longevity of seven years, this resulted in incremental costs per QALY of 24 650 Euro.
Conclusion: CRT-D plus OPT may be a cost-effective alternative for the treatment of patients with CHF in NYHA functional class III and IV depending on device longevity.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00392-007-0586-9 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Cost-effectiveness analysis of implantable cardiac devices in patients with systolic heart failure: a US perspective using real world data.
J Med Econ
July 2020
Economics, Reimbursement & Evidence, Medtronic plc, Mounds View, MN, USA.
Heart failure with reduced ejection fraction (HFrEF) has a substantial impact on costs and patients' quality-of-life. This study aimed to estimate the cost-effectiveness of implantable cardioverter defibrillators (ICD), cardiac resynchronization therapy pacemakers (CRT-P), cardiac resynchronization therapy defibrillators (CRT-D), and optimal pharmacologic therapy (OPT) in patients with HFrEF, from a US payer perspective. The analyses were conducted by adapting the UK-based cost-effectiveness analyses (CEA) to the US payer perspective by incorporating real world evidence (RWE) on baseline hospitalization risk and Medicare-specific costs.
View Article and Find Full Text PDFImpact of Degree of Left Ventricular Remodeling on Clinical Outcomes From Cardiac Resynchronization Therapy.
JACC Heart Fail
April 2019
Department of Medicine, Division of Cardiology and Cardiovascular Institute, University of Colorado, Boulder and Aurora, Colorado.
Objectives: This study tested the hypothesis that the extent of left ventricular (LV) eccentric structural remodeling in heart failure with reduced ejection fraction (HFrEF) is directly associated with clinical event responses to cardiac resynchronization therapy (CRT).
Background: Whether the severity of LV structural remodeling influences CRT treatment effects is unknown.
Methods: COMPANION (Comparison of Medical Therapy, Pacing and Defibrillation in Heart Failure) trial data were analyzed retrospectively.
Multipoint left ventricular pacing improves response to cardiac resynchronization therapy with and without pressure-volume loop optimization: comparison of the long-term efficacy of two different programming strategies.
J Interv Card Electrophysiol
March 2019
Department of Arrhythmology, IRCCS Policlinico San Donato, Piazza E. Malan, 20097, San Donato Milanese, MI, Italy.
Purpose: Cardiac resynchronization therapy (CRT) with multipoint left ventricular (LV) pacing (MultiPoint™ Pacing [MPP]) improves long-term LV reverse remodeling, though questions persist about how to program LV pacing vectors and delays. We evaluated if an empirical method of programming MPP vectors and delays between pacing pulses improved CRT response similar to pressure-volume loop (PVL) optimized MPP programming.
Methods: Patients undergoing CRT implant (Quadra Assura MP™ CRT-D and Quartet™ LV lead) received MPP with programmed settings optimized either by PVL measurements at implant (PVL-OPT group) or empirically determined by maximizing the spatial separation between the two cathodes and minimal delays between the three ventricular pacing pulses (MAX-SEP group).
Effect of PR Interval on Outcomes Following Cardiac Resynchronization Therapy: A Secondary Analysis of the COMPANION Trial.
J Cardiovasc Electrophysiol
February 2017
Division of Cardiovascular Medicine, Department of Medicine, Madison, Wisconsin, USA.
Background: Prolonged PR intervals may impair atrioventricular mechanical coupling and adversely affect cardiac performance. We hypothesize that patients with advanced systolic heart failure, wide QRS complexes, and prolonged PR intervals will have improved survival from CRT-D regardless of whether left bundle branch block (LBBB) or non-LBBB is present.
Methods And Results: A total of 308 patients enrolled in the optimal pharmacologic therapy (OPT) and 595 patients in the cardiac resynchronization therapy with defibrillation (CRT-D) arms of the Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure trial were stratified according to normal (≤230 ms) or prolonged PR interval (>230 ms).
A review of economic evaluation models for cardiac resynchronization therapy with implantable cardioverter defibrillators in patients with heart failure.
Eur J Health Econ
December 2016
Department of Pharmacy, University of Groningen, Groningen, The Netherlands.
Objectives: Cardiac resynchronization therapy with a biventricular pacemaker (CRT-P) is an effective treatment for dyssynchronous heart failure (DHF). Adding an implantable cardioverter defibrillator (CRT-D) may further reduce the risk of sudden cardiac death (SCD). However, if the majority of patients do not require shock therapy, the cost-effectiveness ratio of CRT-D compared to CRT-P may be high.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!