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
Pubmed Central ID
- 11712877
International Standard Serial Number (ISSN)
- 0003-4819
Digital Object Identifier (DOI)
- 10.7326/0003-4819-135-10-200111200-00007
Language
- eng
Conference Location
- United States