Cost-utility analysis of the wearable cardioverter defibrillator in high-risk post-myocardial infarction patients in the Spanish healthcare system - Report - MDSpire
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Cost-utility analysis of the wearable cardioverter defibrillator in high-risk post-myocardial infarction patients in the Spanish healthcare system
Economic Evaluation of Wearable Cardioverter Defibrillator Use in High-Risk Patients
Overview
The study evaluates the cost-utility of wearable cardioverter defibrillator (WCD) therapy combined with guideline-directed medical therapy (GDMT) versus GDMT alone in post-myocardial infarction patients with reduced left ventricular ejection fraction. Findings indicate that WCD use can improve health outcomes at an incremental cost-effectiveness ratio below commonly accepted thresholds.
Background
Sudden cardiac death (SCD) is a significant cause of mortality, particularly in patients with reduced left ventricular ejection fraction following myocardial infarction (MI). The wearable cardioverter defibrillator (WCD) serves as a temporary protective measure for high-risk patients before they become eligible for implantable cardioverter defibrillators (ICDs). Understanding the economic implications of WCD use is crucial for healthcare systems aiming to optimize patient outcomes while managing costs.
Data Highlights
Intervention
Life Years
QALYs
Total Costs (€)
Incremental Cost (€)
ICER (€ per QALY)
WCD + GDMT
12.83
9.59
113,290
11,259
26,145
GDMT Alone
12.30
9.16
102,032
-
-
Key Findings
WCD plus GDMT resulted in 0.53 additional life years and 0.43 additional QALYs compared to GDMT alone.
The total lifetime costs for WCD plus GDMT were €113,290 versus €102,032 for GDMT alone.
The incremental cost-effectiveness ratio (ICER) for WCD therapy was €26,145 per QALY gained, below the €30,000 threshold.
The probability of cost-effectiveness for WCD use in early post-MI patients was 78.3%.
WCD therapy is positioned as a temporary option for patients at high risk of sudden cardiac death before ICD eligibility.
Clinical Implications
The findings suggest that incorporating WCD therapy in the management of high-risk post-MI patients can enhance survival and quality of life while remaining cost-effective. Clinicians should consider patient selection and adherence to maximize the benefits of WCD therapy.
Conclusion
WCD use in conjunction with GDMT after myocardial infarction may improve health outcomes at a cost that aligns with established economic thresholds, supporting its adoption in clinical practice.
