Cost-effectiveness of catheter ablation in patients with ventricular tachycardia.
Circulation
; 101(3): 280-8, 2000 Jan 25.
Article
en En
| MEDLINE
| ID: mdl-10645924
ABSTRACT
BACKGROUND:
This study evaluated the cost-effectiveness of catheter ablation therapy versus amiodarone for treating ventricular tachycardia (VT) in patients with structural heart disease. The analysis used a societal perspective for a hypothetical cohort of VT patients with implantable cardioverter-defibrillators, who were experiencing frequent shocks. METHODS ANDRESULTS:
We calculated incremental cost-effectiveness of ablation relative to amiodarone over 5 years after treatment initiation. Event probabilities were from the Chilli randomized clinical trial (Chilli Cooled Ablation System, Cardiac Pathways Corporation, Sunnyvale, Calif), the literature, and a consensus panel. Costs were from 1998 national Medicare reimbursement schedules. Quality-of-life weights (utilities) were estimated using an established preference measurement technique. In a hypothetical cohort of 10 000 patients, 5-year costs were higher for patients undergoing ablation compared with amiodarone therapy ($21 795 versus $19 075). Ablation also produced a greater increase in quality of life (2.78 versus 2.65 quality-adjusted life-years [QALYs]). This yielded a cost-effectiveness ratio of $20 923 per QALY gained for ablation compared with amiodarone. Results were relatively insensitive to assumptions about ablation success and durability. In less severe patients with good ejection fractions who suffer their first VT episode, the incremental cost-effectiveness ratio was $6028 per QALY gained. These cost-effectiveness ratios are within the range generally thought to warrant technology adoption.CONCLUSIONS:
This study demonstrates that, from a societal perspective, catheter ablation appears to be a cost-effective alternative to amiodarone for treating VT patients.
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Banco de datos:
MEDLINE
Asunto principal:
Taquicardia Ventricular
/
Ablación por Catéter
Tipo de estudio:
Clinical_trials
/
Health_economic_evaluation
Límite:
Humans
Idioma:
En
Revista:
Circulation
Año:
2000
Tipo del documento:
Article
País de afiliación:
Estados Unidos