SciELO - Scientific Electronic Library Online

 
vol.39 issue3Coumarin analogue 3-methyl-7H-furo[3,2-g]chromen-7-one as a possible antiparkinsonian agentMethicillin resistance and biofilm production in clinical isolates of Staphylococcus aureus and coagulase-negative Staphylococcus in México author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Indicators

Related links

  • On index processCited by Google
  • Have no similar articlesSimilars in SciELO
  • On index processSimilars in Google

Share


Biomédica

Print version ISSN 0120-4157

Abstract

ATEHORTUA, Sara et al. Cost-utility analysis of an implantable cardioverterdefibrillator for the treatment of patients with ischemic or non-ischemic New York Heart Association class II or III heart failure in Colombia. Biomédica [online]. 2019, vol.39, n.3, pp.502-512.  Epub Sep 30, 2019. ISSN 0120-4157.  https://doi.org/10.7705/biomedica.4235.

Introduction:

The use of an implantable cardioverter-defibrillator reduces the probability of sudden cardiac death in patients with heart failure.

Objective:

To determine the cost-utility relationship of an implantable cardioverterdefibrillator compared to optimal pharmacological therapy for patients with ischemic or nonischemic New York Heart Association class II or III (NYHA II-III) heart failure in Colombia.

Materials and methods:

We developed a Markov model including costs, effectiveness, and quality of life from the perspective of the Colombian health system. For the baseline case, we adopted a time horizon of 10 years and discount rates of 3% for costs and 3.5% for benefits. The transition probabilities were obtained from a systematic review of the literature. The outcome used was the quality-adjusted life years. We calculated the costs by consulting with the manufacturers of the device offered in the Colombian market and using national-level pricing manuals. We conducted probabilistic and deterministic sensitivity analyses.

Results:

In the base case, the incremental cost-effectiveness ratio for the implantable cardioverter-defibrillator was USD$ 13,187 per quality-adjusted life year gained. For a willingness-to-pay equivalent to three times the gross domestic product per capita as a reference (USD$ 19,139 in 2017), the device would be a cost-effective strategy for the Colombian health system. However, the result may change according to the time horizon, the probability of death, and the price of the device.

Conclusions:

The use of an implantable cardioverter-defibrillator for preventing sudden cardiac death in patients with heart failure would be a cost-effective strategy for Colombia. The results should be examined considering the uncertainty

Keywords : Heart failure; defibrillators; implantable; death, sudden, cardiac; cost-benefit analysis; Colombia.

        · abstract in Spanish     · text in English     · English ( pdf )