Document Detail

Economic assessment of cardiac resynchronization therapy.
MedLine Citation:
PMID:  21070719     Owner:  NLM     Status:  In-Process    
INTRODUCTION AND OBJECTIVES: Cardiac resynchronization devices have been shown to be effective in treating heart failure. They reduce overall mortality, heart failure mortality and hospitalizations due to heart failure. The aim of this study was to compare the cost-effectiveness of cardiac resynchronization therapy (CRT) with that of optimal drug therapy (ODT) by carrying out an economic assessment in the Spanish healthcare setting.
METHODS: An existing model was adapted for use in the Spanish healthcare setting. The effectiveness of cardiac resynchronization therapy was determined from published systematic reviews. The costs of the various interventions were determined using a range of Spanish data sources. The model adopted the perspective of the public health system and the time horizon considered was the remainder of the patient's life. The outcome variables were life-years gained and quality-adjusted life-years (QALYs) gained.
RESULTS: Overall, ODT, CRT and CRT with a defibrillator resulted in gains of 2.11, 2.8 and 3.19 QALYs, respectively, at a cost of €11,722, €31,629 and €52,592, respectively. Consequently, each QALY gained with CRT relative to ODT involved the consumption of €28,612 of additional resources. Similarly, the use of CRT with a defibrillator cost an additional €53,547 per QALY relative to CRT without a defibrillator.
CONCLUSIONS: The use of CRT without a defibrillator could be a cost-effective alternative to ODT for treating heart failure in a carefully selected group of patients. The study results were sensitive to uncertainties in many of the variables used in the model.
Daniel Callejo; Mercedes Guerra; Antonio Hernández-Madrid; Juan A Blasco
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Revista española de cardiología     Volume:  63     ISSN:  1579-2242     ISO Abbreviation:  Rev Esp Cardiol     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0404277     Medline TA:  Rev Esp Cardiol     Country:  Spain    
Other Details:
Languages:  eng; spa     Pagination:  1235-43     Citation Subset:  IM    
Unidad de Evaluación de Tecnologías Sanitarias (UETS), Agencia Laín Entralgo, Comunidad de Madrid, Madrid, España.
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Comment In:
Rev Esp Cardiol. 2010 Nov;63(11):1230-1   [PMID:  21070717 ]

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