Potential cost-effectiveness of prophylactic use of the implantable cardioverter defibrillator or amiodarone after myocardial infarction.

Journal Article (Journal Article)

BACKGROUND: Clinical trials have shown that implantable cardioverter defibrillators (ICDs) improve survival in patients with sustained ventricular arrhythmias. OBJECTIVE: To determine the efficacy necessary to make prophylactic ICD or amiodarone therapy cost-effective in patients with myocardial infarction. DESIGN: Markov model-based cost utility analysis. DATA SOURCES: Survival, cardiac death, and inpatient costs were estimated on the basis of the Myocardial Infarction Triage and Intervention registry. Other data were derived from the literature. TARGET POPULATION: Patients with past myocardial infarction who did not have sustained ventricular arrhythmia. TIME HORIZON: Lifetime. PERSPECTIVE: Societal. INTERVENTIONS: ICD or amiodarone compared with no treatment. OUTCOME MEASURES: Life-years, quality-adjusted life-years (QALYs), costs, number needed to treat, and incremental cost-effectiveness. RESULTS OF BASE-CASE ANALYSIS: Compared with no treatment, ICD use led to the greatest QALYs and the highest expenditures. Amiodarone use resulted in intermediate QALYs and costs. To obtain acceptable cost-effectiveness thresholds (

Full Text

Duke Authors

Cited Authors

  • Sanders, GD; Hlatky, MA; Every, NR; McDonald, KM; Heidenreich, PA; Parsons, LS; Owens, DK

Published Date

  • November 20, 2001

Published In

Volume / Issue

  • 135 / 10

Start / End Page

  • 870 - 883

PubMed ID

  • 11712877

International Standard Serial Number (ISSN)

  • 0003-4819

Digital Object Identifier (DOI)

  • 10.7326/0003-4819-135-10-200111200-00007


  • eng

Conference Location

  • United States