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(Circulation. 2002;105:e9191.)
© 2002 American Heart Association, Inc.

Cardiovascular News

Ruth SoRelle, MPH

Circulation Newswriter

Implantable Defibrillators Prove Moderately Cost Effective

Implantable defibrillators save lives and are somewhat more cost-effective than intensive treatment with antiarrhythmic drugs. The real cost saving, though, comes from reduced hospital stays, according to investigators in the Antiarrhythmic Versus Implantable Defibrillators (AVID) trial. In their analysis, Greg Larsen, MD, of the Portland (Oregon) Veterans Affairs Medical Center, and his AVID colleagues demonstrated a moderate cost-benefit favoring the use of implantable defibrillators as a secondary preventive method against life-threatening arrhythmias.

In the study, detailed in this week’s issue of Circulation (Circulation. 2002;105:2049–2057), the physicians analyzed initial and repeat hospitalizations, including emergency room and day surgery stays, as well as the cost of antiarrhythmic drugs on 1008 patients. They also evaluated medical encounters and expenses collected on a subgroup of 237 patients and used statistical modeling to apply these charges to the other patients.

At 3 years, the authors wrote, the total costs were $71 421 for a patient who takes antiarrhythmic drugs and $85 522 for a patient on an implantable defibrillator. The defibrillator provided a 0.21-year survival benefit over the treatment with antiarrhythmic drugs. Under the model the investigators used for their analysis, the base case cost-effectiveness ratio was $66 677 per year of life saved by the implanted defibrillator, compared with patients on antiarrhythmic drugs. The cost-effectiveness ratio was $68 000 per year of life saved for 6 years, and $80 000 for 20 years.

The Role of C-Reactive Protein in Heart Disease Strengthens
Levels of serum C-reactive protein were increased in patients with sudden death, particularly those with acute rupture of atheromas, . . . [Full Text of this Article]