PMID- 23006489
OWN - NLM
STAT- MEDLINE
DCOM- 20130410
LR  - 20151119
IS  - 1471-6348 (Electronic)
IS  - 0266-4623 (Linking)
VI  - 28
IP  - 4
DP  - 2012 Oct
TI  - Cost-effectiveness of cardiac resynchronization therapy: perspective from 
      Argentina.
PG  - 429-35
LID - 10.1017/S0266462312000505 [doi]
AB  - OBJECTIVES: Cardiac resynchronization therapy (CRT) has recently been shown to 
      reduce both mid-term and long-term mortality in patients with mild heart failure. 
      Although proven effective, it is unclear whether CRT is cost-effective in low and 
      middle-income countries (LMIC). Therefore, we set out to analyze the 
      cost-effectiveness of CRT in Argentina in patients with New York Heart 
      Association (NYHA) functional class (FC) I or II heart failure (HF). We chose to 
      compare patients receiving optimal medical treatment (OMT) and CRT with those 
      patients receiving only OMT. METHODS: We constructed a Markov model with a cohort 
      simulation, and a life-time horizon to assess costs, life-years, and 
      quality-adjusted life-year (QALY) gained as a result of treatment with both CRT 
      and OMT from an Argentine third party payer perspective. We included patients who 
      met the following criteria: left ventricular ejection fraction (LVEF) </= 40 
      percent, sinus rhythm with a QRS >/= 120 msec, and NYHA FC I-II HF. The results 
      were expressed as cost per life-year and QALY gained in international dollars 
      (ID$) for the year 2009. RESULTS: For the base case analysis performed, we 
      started at a fixed age of 65. After applying a 3 percent annual discount rate, 
      the incremental cost-effectiveness ratio (ICER) was 38.005 ID$ per year of life 
      gained and 34.185 ID$ per QALY gained. CONCLUSIONS: Long-term treatment with CRT 
      appears to be cost-effective in Argentina compared with patients treated solely 
      with OMT. Similar analysis should be performed to determine if this treatment 
      option is cost-effective in other LMIC.
FAU - Poggio, Rosana
AU  - Poggio R
AD  - Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, 
      Argentina. rpoggio@iecs.org.ar
FAU - Augustovsky, Federico
AU  - Augustovsky F
FAU - Caporale, Joaquin
AU  - Caporale J
FAU - Irazola, Vilma
AU  - Irazola V
FAU - Miriuka, Santiago
AU  - Miriuka S
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20120924
PL  - England
TA  - Int J Technol Assess Health Care
JT  - International journal of technology assessment in health care
JID - 8508113
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Argentina
MH  - Cardiac Resynchronization Therapy/*economics/psychology/statistics & numerical 
      data
MH  - Cohort Studies
MH  - Cost-Benefit Analysis
MH  - Heart Failure/diagnosis/*economics
MH  - Humans
MH  - Markov Chains
MH  - Quality-Adjusted Life Years
MH  - Surveys and Questionnaires
MH  - Survival Analysis
EDAT- 2012/09/26 06:00
MHDA- 2013/04/11 06:00
CRDT- 2012/09/26 06:00
PHST- 2012/09/26 06:00 [entrez]
PHST- 2012/09/26 06:00 [pubmed]
PHST- 2013/04/11 06:00 [medline]
AID - S0266462312000505 [pii]
AID - 10.1017/S0266462312000505 [doi]
PST - ppublish
SO  - Int J Technol Assess Health Care. 2012 Oct;28(4):429-35. doi: 
      10.1017/S0266462312000505. Epub 2012 Sep 24.