Abstract
Aims Patients receiving cardiac resynchronization therapy defibrillators (CRT-Ds) are likely to undergo one or more device replacements, mainly for battery depletion. We assessed the economic impact of battery depletion on the overall cost of CRT-D treatment from the perspectives of the healthcare system and the hospital. We also compared devices of different generations and from different manufacturers in terms of therapy cost. Methods and results We analysed data on 1792 CRT-Ds implanted in 1399 patients in 9 Italian centres. We calculated the replacement probability and the total therapy cost over 6 years, stratified by device generation and manufacturer. Public tariffs from diagnosis-related groups were used together with device prices and hospitalization costs. Generators were from 3 manufacturers: Boston Scientific (667, 37%), Medtronic (973, 54%), and St Jude Medical (152, 9%). The replacement probability at 6 years was 83 and 68% for earlier- and recent-generation devices, respectively. The need for replacement increased total therapy costs by more than 50% over the initial implantation cost for hospitals and by more than 30% for healthcare system. The improved longevity of recent-generation CRT-Ds reduced the therapy cost by ∼6% in both perspectives. Among recent-generation CRT-Ds, the replacement probability of devices from different manufacturers ranged from 12 to 70%. Consequently, the maximum difference in therapy cost between manufacturers was 40% for hospitals and 19% for the healthcare system. Conclusions Differences in CRT-D longevity strongly affect the overall therapy cost. While the use of recent-generation devices has reduced the cost, significant differences exist among currently available systems.
| Original language | English |
|---|---|
| Pages (from-to) | 1349-1356 |
| Number of pages | 8 |
| Journal | Europace |
| Volume | 19 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - Aug 1 2017 |
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Keywords
- Battery
- Cardiac resynchronization therapy
- Cost analysis
- Defibrillator
- Device longevity
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)
Cite this
The economic impact of battery longevity in implantable cardioverter-defibrillators for cardiac resynchronization therapy : The hospital and healthcare system perspectives. / Landolina, Maurizio; Morani, Giovanni; Curnis, Antonio; Vado, Antonello; D'Onofrio, Antonio; Bianchi, Valter; Stabile, Giuseppe; Crosato, Martino; Petracci, Barbara; Ceriotti, Carlo; Bontempi, Luca; Morosato, Martina; Ballari, Gian Paolo; Gasparini, Maurizio.
In: Europace, Vol. 19, No. 8, 01.08.2017, p. 1349-1356.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The economic impact of battery longevity in implantable cardioverter-defibrillators for cardiac resynchronization therapy
T2 - The hospital and healthcare system perspectives
AU - Landolina, Maurizio
AU - Morani, Giovanni
AU - Curnis, Antonio
AU - Vado, Antonello
AU - D'Onofrio, Antonio
AU - Bianchi, Valter
AU - Stabile, Giuseppe
AU - Crosato, Martino
AU - Petracci, Barbara
AU - Ceriotti, Carlo
AU - Bontempi, Luca
AU - Morosato, Martina
AU - Ballari, Gian Paolo
AU - Gasparini, Maurizio
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Aims Patients receiving cardiac resynchronization therapy defibrillators (CRT-Ds) are likely to undergo one or more device replacements, mainly for battery depletion. We assessed the economic impact of battery depletion on the overall cost of CRT-D treatment from the perspectives of the healthcare system and the hospital. We also compared devices of different generations and from different manufacturers in terms of therapy cost. Methods and results We analysed data on 1792 CRT-Ds implanted in 1399 patients in 9 Italian centres. We calculated the replacement probability and the total therapy cost over 6 years, stratified by device generation and manufacturer. Public tariffs from diagnosis-related groups were used together with device prices and hospitalization costs. Generators were from 3 manufacturers: Boston Scientific (667, 37%), Medtronic (973, 54%), and St Jude Medical (152, 9%). The replacement probability at 6 years was 83 and 68% for earlier- and recent-generation devices, respectively. The need for replacement increased total therapy costs by more than 50% over the initial implantation cost for hospitals and by more than 30% for healthcare system. The improved longevity of recent-generation CRT-Ds reduced the therapy cost by ∼6% in both perspectives. Among recent-generation CRT-Ds, the replacement probability of devices from different manufacturers ranged from 12 to 70%. Consequently, the maximum difference in therapy cost between manufacturers was 40% for hospitals and 19% for the healthcare system. Conclusions Differences in CRT-D longevity strongly affect the overall therapy cost. While the use of recent-generation devices has reduced the cost, significant differences exist among currently available systems.
AB - Aims Patients receiving cardiac resynchronization therapy defibrillators (CRT-Ds) are likely to undergo one or more device replacements, mainly for battery depletion. We assessed the economic impact of battery depletion on the overall cost of CRT-D treatment from the perspectives of the healthcare system and the hospital. We also compared devices of different generations and from different manufacturers in terms of therapy cost. Methods and results We analysed data on 1792 CRT-Ds implanted in 1399 patients in 9 Italian centres. We calculated the replacement probability and the total therapy cost over 6 years, stratified by device generation and manufacturer. Public tariffs from diagnosis-related groups were used together with device prices and hospitalization costs. Generators were from 3 manufacturers: Boston Scientific (667, 37%), Medtronic (973, 54%), and St Jude Medical (152, 9%). The replacement probability at 6 years was 83 and 68% for earlier- and recent-generation devices, respectively. The need for replacement increased total therapy costs by more than 50% over the initial implantation cost for hospitals and by more than 30% for healthcare system. The improved longevity of recent-generation CRT-Ds reduced the therapy cost by ∼6% in both perspectives. Among recent-generation CRT-Ds, the replacement probability of devices from different manufacturers ranged from 12 to 70%. Consequently, the maximum difference in therapy cost between manufacturers was 40% for hospitals and 19% for the healthcare system. Conclusions Differences in CRT-D longevity strongly affect the overall therapy cost. While the use of recent-generation devices has reduced the cost, significant differences exist among currently available systems.
KW - Battery
KW - Cardiac resynchronization therapy
KW - Cost analysis
KW - Defibrillator
KW - Device longevity
UR - http://www.scopus.com/inward/record.url?scp=85037733837&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85037733837&partnerID=8YFLogxK
U2 - 10.1093/europace/euw176
DO - 10.1093/europace/euw176
M3 - Article
AN - SCOPUS:85037733837
VL - 19
SP - 1349
EP - 1356
JO - Europace
JF - Europace
SN - 1099-5129
IS - 8
ER -