{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T10:37:41Z","timestamp":1761561461356},"reference-count":24,"publisher":"Wiley","issue":"s9","license":[{"start":{"date-parts":[[2003,9,5]],"date-time":"2003-09-05T00:00:00Z","timestamp":1062720000000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2003,9]]},"abstract":"<jats:p> <jats:italic>Introduction:<\/jats:italic> Implantable cardioverter defibrillator (ICD) therapy is indicated for patients at risk for sudden cardiac death (SCD) due to ventricular tachycardia (VT) or ventricular fibrillation (VF). The high relative cost of therapy with the ICD versus antiarrhythmic drugs has raised questions regarding its cost\u2010effectiveness. To address these questions, we review the literature on ICD cost\u2010effectiveness.<\/jats:p><jats:p> <jats:italic>Methods and Results:<\/jats:italic> MEDLINE and other databases were searched for articles published since 1980 reporting original data on the cost\u2010effectiveness of ICD versus drug therapy for patients at risk for SCD. Data on costs and life\u2010years were abstracted and studies grouped into decision analysis models and trial\u2010based analyses. Cost\u2010effectiveness ratios were inflated to 2002 US dollars. Thirteen economic studies were included in this review: 6 decision\u2010analytic models, 4 economic analysis alongside randomized controlled trials, and 1 observational study. Two additional studies evaluated the cost\u2010effectiveness of ICDs stratified by mortality risk. Studies varied in time horizon, and in all but one study ICD therapy was more costly than drug therapy. Early models assumed larger survival benefits than were observed in subsequent trials; therefore, ICDs appeared to be more cost\u2010effective (i.e., $28,000\u2013$60,000 per life\u2010year gained). Three large clinical trial\u2010based studies estimated that the cost per life\u2010year gained was between $30,181 and $185,000. Stratified analyses show that patients at higher risk for mortality due to structural heart disease (e.g., left ventricular ejection fraction &lt;35%) benefit more from ICD therapy, resulting in lower cost\u2010effectiveness ratios.<\/jats:p><jats:p> <jats:italic>Conclusion:<\/jats:italic> ICD therapy continues to evolve with changing methods of implantation and improving technology. Current evidence suggests that ICDs may be a cost\u2010effective option in patients at high risk for VT\/VF. The cost\u2010effectiveness of ICD therapy for primary and secondary prevention of SCD depends upon patient characteristics that influence their prior risk of mortality. Further research on patient selection criteria and the measurement of health\u2010related quality of life is required. <jats:italic>(J Cardiovasc Electrophysiol, Vol. 14, pp. S99\u2010S103, September 2003, Suppl.)<\/jats:italic><\/jats:p>","DOI":"10.1046\/j.1540-8167.14.s9.3.x","type":"journal-article","created":{"date-parts":[[2010,8,16]],"date-time":"2010-08-16T09:46:49Z","timestamp":1281952009000},"source":"Crossref","is-referenced-by-count":20,"title":["Cost\u2010Effectiveness of the Implantable Cardioverter Defibrillator:"],"prefix":"10.1111","volume":"14","author":[{"given":"LARRY D.","family":"LYND","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"BERNIE J.","family":"O'BRIEN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2003,9,5]]},"reference":[{"key":"e_1_2_5_2_2","first-page":"1567","article-title":"A comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from near\u2010fatal ventricular arrhythmias","volume":"337","author":"The Antiarrhythmics Versus Implantable Defibrillators (AVID) Investigators","year":"1997","journal-title":"N Engl J Med"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199612263352601"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.101.11.1297"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa013474"},{"key":"e_1_2_5_6_2","unstructured":"Ontario Guidelines for Economic Analysis of Pharmaceutical Products. Toronto Canada : Ontario Ministry of Health and Long Term Care 1994 Report No. 2227446."},{"key":"e_1_2_5_7_2","unstructured":"Guidelines for Economic Evaluation of Pharmaceuticals: Canada.Second Edition. Ottawa Canada : The Canadian Coordinating Office for Health Technology Assessment 1997."},{"key":"e_1_2_5_8_2","unstructured":"Guidance for Sponsors and Manufacturers: Technology Appraisals Process Series No. 5. London UK : National Institute for Clinical Excellence 2001 Report No. N0014."},{"key":"e_1_2_5_9_2","unstructured":"International Academy of Cardiology 2002.MADIT II findings support prophylactic use of ICDs. 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