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Implantable cardioverter defibrillator therapy is cost effective for primary prevention patients in Taiwan: An analysis from the Improve SCA trial
- Source :
- PLoS ONE, Vol 15, Iss 11, p e0241697 (2020), PLoS ONE
- Publication Year :
- 2020
- Publisher :
- Public Library of Science (PLoS), 2020.
-
Abstract
- Objective Implantable cardiac defibrillators (ICDs) for primary prevention (PP) of sudden cardiac arrest (SCA) are well-established but underutilized globally. The Improve SCA study has identified a cohort of patients called 1.5 primary prevention (1.5PP) based on PP patients with the presence of certain risk factors. We evaluated the cost-effectiveness of ICD therapy compared to no ICD among the PP population and the subset of 1.5PP patients in Taiwan. Methods A Markov model was run over a lifetime time horizon from the Taiwan payer perspective. Mortality and utility estimates were obtained from the literature (PP) and the IMPROVE SCA trial (1.5PP). Cost inputs were obtained from the Taiwan National Health Insurance Administration (NHIA), Ministry of Health and Welfare. We used a willingness-to-pay (WTP) threshold of NT$2,100,000, as established through standard WTP research methods and in alignment with World Health Organization recommendations. Results The total discounted costs for ICD therapy and no ICD therapy were NT$1,664,259 and NT$646,396 respectively for PP, while they were NT$2,410,603 and NT$905,881 respectively for 1.5PP. Total discounted QALYs for ICD therapy and no ICD therapy were 6.48 and 4.98 respectively for PP, while they were 10.78 and 7.71 respectively for 1.5PP. The incremental cost effectiveness ratio was NT$708,711 for PP and NT$441,153 for 1.5PP, therefore ICD therapy should be considered cost effective for PP and highly cost effective for 1.5PP. Conclusions ICD therapy compared to no ICD therapy is cost-effective in the whole PP population and highly cost-effective in the subset 1.5PP population in Taiwan.
- Subjects :
- Male
Medical Implants
Economics
Epidemiology
medicine.medical_treatment
Social Sciences
Sudden Cardiac Death
Sudden cardiac death
Geographical Locations
Risk Factors
Medicine and Health Sciences
Medicine
education.field_of_study
Multidisciplinary
Cost-effectiveness analysis
Implantable cardioverter-defibrillator
Markov Chains
Defibrillators, Implantable
Primary Prevention
Cohort
Engineering and Technology
Female
Quality-Adjusted Life Years
medicine.symptom
Incremental cost-effectiveness ratio
Research Article
Biotechnology
medicine.medical_specialty
Asia
Patients
Science
Population
Cost-Effectiveness Analysis
Cardiology
Taiwan
Bioengineering
Humans
education
Heart Failure
Inpatients
business.industry
Biology and Life Sciences
Sudden cardiac arrest
medicine.disease
Economic Analysis
Quality-adjusted life year
Health Care
Death, Sudden, Cardiac
Medical Risk Factors
Emergency medicine
People and Places
Medical Devices and Equipment
business
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 15
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.doi.dedup.....3d6f9db608279921655003349c565cc2