Key result
ICDs cost ~$67,000 per year of life saved compared to AADs.
Why the study?
The implantable cardioverter-defibrillator is an effective but expensive device, and its cost-effectiveness compared with antiarrhythmic drug therapy for secondary prevention was unclear.
Is the implantable cardioverter-defibrillator cost-effective compared to antiarrhythmic drugs in survivors of serious ventricular tachyarrhythmias?
RCT (n=1,008)
Is the implantable cardioverter-defibrillator cost-effective compared to antiarrhythmic drugs in survivors of serious ventricular tachyarrhythmias?
Effect estimate: ICER $66 677 per year of life saved (95% CI $30 761 to $154 768)
The ICD is moderately cost-effective for secondary prevention of life-threatening ventricular arrhythmias compared to antiarrhythmic drug therapy.
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May inform ICD decisions for secondary prevention at this threshold; leaves open randomized confirmation with contemporary therapies.
Larsen et al. (2002) conducted an RCT in Life-threatening ventricular arrhythmias (n=1,008). Implantable cardioverter-defibrillator (ICD) vs. Antiarrhythmic drug (AAD) therapy was evaluated on Cost-effectiveness ratio (cost per year of life saved) (ICER $66 677 per year of life saved, 95% CI $30 761 to $154 768). The implantable cardioverter-defibrillator had a base-case cost-effectiveness ratio of $66,677 per year of life saved (95% CI, $30,761-$154,768) compared with antiarrhythmic drugs.
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