Cost-Effectiveness of the Implantable Cardioverter-Defibrillator
Key result
Implantable cardioverter-defibrillator therapy yielded an incremental cost-effectiveness ratio of C$213,543 per life-year gained compared to amiodarone, which is not considered attractive.
Why the study?
Is the implantable cardioverter-defibrillator (ICD) cost-effective compared to amiodarone in survivors of previous VT or VF?
Population
430 survivors of previous ventricular tachycardia (VT) or fibrillation (VF)
Comparison
Implantable cardioverter-defibrillator (ICD) vs Amiodarone
Design
Other
Follow-up
6.3 years
Authors
Discussion
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Member takes
Implication
May limit ICD use for secondary prevention on cost grounds; leaves open value in LVEF <35% subgroups.
Study Design
Type
RCT (n=430)
Multicenter
Yes
Structured PICO
Is the implantable cardioverter-defibrillator (ICD) cost-effective compared to amiodarone in survivors of previous VT or VF?
P
Population
430 survivors of previous ventricular tachycardia (VT) or fibrillation (VF)
I
Intervention
Implantable cardioverter-defibrillator (ICD)
C
Comparator
Amiodarone
O
Outcome
Incremental cost-effectiveness (ratio of the difference in cost to the difference in life expectancy)
Main Result
Effect estimate: ICER C$213 543
ICD therapy for secondary prevention of VT/VF is not cost-effective by standard thresholds overall, but offers better value in patients with LVEF <35%.
Cite This Study
OʼBrien et al. (2001) conducted an RCT in Survivors of previous ventricular tachycardia (VT) or fibrillation (VF) (n=430). Implantable cardioverter-defibrillator (ICD) vs. Amiodarone was evaluated on Incremental cost-effectiveness ratio (cost per life-year gained) (ICER C$213 543). Implantable cardioverter-defibrillator therapy yielded an incremental cost-effectiveness ratio of C$213,543 per life-year gained compared to amiodarone, which is not considered attractive.