Gandjour, Afschin, Holler, Astrid and Adarkwah, Charles Christian ORCID: 0000-0002-1073-5866 (2011). Cost-Effectiveness of Implantable Defibrillators after Myocardial Infarction Based on 8-Year Follow-Up Data (MADIT II). Value Health, 14 (6). S. 812 - 818. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1524-4733

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Abstract

Objectives: About 190,000 Germans experience a myocardial infarction each year. Of these, 25% may be eligible for an implantable cardioverter defibrillator (ICD) due to low left ventricular ejection fraction. Given the high costs of implantation, the purpose of this study was to assess the cost-effectiveness of ICDs compared to conventional therapy in patients with an ejection fraction 30% or less after MI in Germany. Methods: The economic evaluation was performed from the perspective of the German statutory health insurance. To simulate costs and effectiveness over lifetime, a Markov model was constructed with seven health states. The model was based on 8-year follow-up data for ICD implantation after myocardial infarction (MADIT II), which was published recently. Results: The analysis shows that ICD implantation compared to conventional therapy in patients fulfilling MADIT-II criteria has a cost-effectiveness ratio of (sic)44,736 per quality-adjusted life year gained. If every patient insured by the statutory health insurance and fulfilling the MADIT-II criteria would receive an ICD, the model suggests expenditures between (sic)173 million and (sic)1.7 billion per year. Conclusions: ICD therapy cannot be considered clearly cost-effective when compared to many well-accepted interventions. If policy makers decide to reimburse ICDs in the MADIT-II population, they will need to either raise premiums or abandon coverage for other currently funded medical interventions.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Gandjour, AfschinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Holler, AstridUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Adarkwah, Charles ChristianUNSPECIFIEDorcid.org/0000-0002-1073-5866UNSPECIFIED
URN: urn:nbn:de:hbz:38-489232
DOI: 10.1016/j.jval.2011.02.1180
Journal or Publication Title: Value Health
Volume: 14
Number: 6
Page Range: S. 812 - 818
Date: 2011
Publisher: ELSEVIER SCIENCE INC
Place of Publication: NEW YORK
ISSN: 1524-4733
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
QUALITY-OF-LIFE; CARDIOVERTER-DEFIBRILLATORS; PROPHYLACTIC IMPLANTATION; HEART-FAILURE; PREVENTION; TRIAL; CONSEQUENCES; GUIDELINES; SURVIVAL; THERAPYMultiple languages
Economics; Health Care Sciences & Services; Health Policy & ServicesMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/48923

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