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Economic Analysis of a Randomized Trial of Biventricular Pacing in Canada
Author(s) -
BENTKOVER JUDITH D.,
DORIAN PAUL,
THIBAULT BERNARD,
GARDNER MARTIN
Publication year - 2007
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2007.00577.x
Subject(s) - medicine , cardiac resynchronization therapy , heart failure , randomized controlled trial , population , adverse effect , resource use , emergency medicine , cardiology , ejection fraction , natural resource economics , economics , environmental health
Background: Congestive heart failure (CHF) has been shown to affect 5% of the Canadian adult population, and leads to 9.5 deaths per 100 cardiac‐related hospitalizations in Canada. The economic outcomes from biventricular pacing for heart failure are not well understood. This study analyzes resource utilization and related costs associated with CHF for patients who receive standard implantable cardiac defibrillators (ICDs) versus those who receive ICD plus biventricular pacing or cardiac resynchronization therapy (CRT).Methods: The Canadian analysis of resynchronization therapy in heart failure (CART‐HF) study included 72 patients with New York Heart Association class II‐IV CHF requiring an ICD. Patients were randomized to receive either ICD + CRT treatment or ICD treatment alone. Medical resource utilization data were collected for 6 months following treatment and were applied to representative costs for the provinces of Quebec and Ontario. Resource utilization was subcategorized into pharmacological therapy, physician visits, hospitalizations, adverse events, and productivity losses.Results: Post‐treatment, per patient costs for the CRT + ICD treatment group were less than the follow‐up costs for patients receiving ICD treatment only in each province. Mean savings for patients receiving biventricular therapy were CAD$2,420 in Quebec and CAD$2,085 in Ontario during the 6‐month follow‐up.Conclusions: These analyses indicate that savings in post‐implant health‐care utilization (hospitalizations and pharmacological therapy) can offset some of the device and procedural costs associated with CRT devices.