TY - JOUR
AU - Mora, Guillermo
AB - AbstractIntroduction: The use of an implantable cardioverter-defibrillator reduces the probability of sudden cardiac death in patients with heart failure.Objective: To determine the cost-utility relationship of an implantable cardioverterdefibrillator compared to optimal pharmacological therapy for patients with ischemic or nonischemic New York Heart Association class II or III (NYHA II-III) heart failure in Colombia.Materials and methods: We developed a Markov model including costs, effectiveness, and quality of life from the perspective of the Colombian health system. For the baseline case, we adopted a time horizon of 10 years and discount rates of 3% for costs and 3.5% for benefits. The transition probabilities were obtained from a systematic review of the literature. The outcome used was the quality-adjusted life years. We calculated the costs by consulting with the manufacturers of the device offered in the Colombian market and using national-level pricing manuals. We conducted probabilistic and deterministic sensitivity analyses.Results: In the base case, the incremental cost-effectiveness ratio for the implantable cardioverter-defibrillator was USD$ 13,187 per quality-adjusted life year gained. For a willingness-to-pay equivalent to three times the gross domestic product per capita as a reference (USD$ 19,139 in 2017), the device would be a cost-effective strategy for the Colombian health system. However, the result may change according to the time horizon, the probability of death, and the price of the device.Conclusions: The use of an implantable cardioverter-defibrillator for preventing sudden cardiac death in patients with heart failure would be a cost-effective strategy for Colombia. The results should be examined considering the uncertainty
TI - Cost-utility analysis of an implantable cardioverterdefibrillator for the treatment of patients with ischemic or non-ischemic New York Heart Association class II or III heart failure in Colombia
JF - Biomédica
DO - 10.7705/biomedica.4235
DA - 2019-09-01
UR - https://www.deepdyve.com/lp/pubmed-central/cost-utility-analysis-of-an-implantable-cardioverterdefibrillator-for-EcXq0Qek6W
SP - 502
EP - 512
VL - 39
IS - 3
DP - DeepDyve
ER -