November 20, 2001Annals of Internal Medicine
Potential Cost-Effectiveness of Prophylactic Use of the Implantable Cardioverter Defibrillator or Amiodarone after Myocardial Infarction
Key result
In patients with past myocardial infarction and ejection fraction ≤0.3, the cost-effectiveness of amiodarone vs no therapy was $43,100/QALY, and ICD vs amiodarone was $71,800/QALY.
Why the study?
Is prophylactic ICD or amiodarone therapy cost-effective compared with no treatment in patients with past myocardial infarction without sustained ventricular arrhythmia?
Population
Patients with past myocardial infarction who did not have sustained ventricular arrhythmia.
Comparison
Prophylactic implantable cardioverter… vs No treatment
Design
Other
Follow-up
Lifetime
Authors
Discussion
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Member takes
Implication
These ratios suggest potential cost-effectiveness for both therapies; leaves open whether findings hold with contemporary regimens and costs.
Structured PICO
Is prophylactic ICD or amiodarone therapy cost-effective compared with no treatment in patients with past myocardial infarction without sustained ventricular arrhythmia?
P
Population
Patients with past myocardial infarction who did not have sustained ventricular arrhythmia.
I
Intervention
Prophylactic implantable cardioverter defibrillator (ICD) or amiodarone therapy
C
Comparator
No treatment
O
Outcome
Life-years, quality-adjusted life-years (QALYs), costs, number needed to treat, and incremental cost-effectiveness
Prophylactic use of ICD or amiodarone in post-MI patients with severely depressed left ventricular function may provide substantial clinical benefit at an acceptable cost.
Cite This Study
Sanders et al. (2001) studied Myocardial infarction. Implantable cardioverter defibrillator (ICD) or amiodarone vs. No treatment was evaluated on Life-years, quality-adjusted life-years (QALYs), costs, number needed to treat, and incremental cost-effectiveness. In patients with past myocardial infarction and ejection fraction ≤0.3, the cost-effectiveness of amiodarone vs no therapy was $43,100/QALY, and ICD vs amiodarone was $71,800/QALY.