The economic impact of battery longevity in implantable cardioverter-defibrillators for cardiac resynchronization therapy: The hospital and healthcare system perspectives

Maurizio Landolina, Giovanni Morani, Antonio Curnis, Antonello Vado, Antonio D'Onofrio, Valter Bianchi, Giuseppe Stabile, Martino Crosato, Barbara Petracci, Carlo Ceriotti, Luca Bontempi, Martina Morosato, Gian Paolo Ballari, Maurizio Gasparini

Research output: Contribution to journalArticle

1 Citation (Scopus)

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 languageEnglish
Pages (from-to)1349-1356
Number of pages8
JournalEuropace
Volume19
Issue number8
DOIs
Publication statusPublished - Aug 1 2017

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Cardiac Resynchronization Therapy
Implantable Defibrillators
Economics
Delivery of Health Care
Costs and Cost Analysis
Defibrillators
Equipment and Supplies
Therapeutics
Hospital Costs
Diagnosis-Related Groups
Hospitalization

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 journalArticle

Landolina, M, Morani, G, Curnis, A, Vado, A, D'Onofrio, A, Bianchi, V, Stabile, G, Crosato, M, Petracci, B, Ceriotti, C, Bontempi, L, Morosato, M, Ballari, GP & Gasparini, M 2017, 'The economic impact of battery longevity in implantable cardioverter-defibrillators for cardiac resynchronization therapy: The hospital and healthcare system perspectives', Europace, vol. 19, no. 8, pp. 1349-1356. https://doi.org/10.1093/europace/euw176
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. / The economic impact of battery longevity in implantable cardioverter-defibrillators for cardiac resynchronization therapy : The hospital and healthcare system perspectives. In: Europace. 2017 ; Vol. 19, No. 8. pp. 1349-1356.
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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.",
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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

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