{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T16:57:32Z","timestamp":1758473852399},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,9,2]],"date-time":"2013-09-02T00:00:00Z","timestamp":1378080000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Although randomized trials have shown the beneficial effect on survival of an implantable cardioverter defibrillator (ICD) as primary prevention therapy in selected patients, data concerning the cost\u2010effectiveness in routine clinical practice remain scarce. Accordingly, the purpose of this study was to assess the cost\u2010effectiveness of primary prevention ICD implantation in the real world.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients receiving primary prevention single\u2010chamber or dual\u2010chamber ICD implantation at the Leiden University Medical Center were included in the study. Using a Markov model, lifetime cost, life years (LYs), and gained quality\u2010adjusted life years (QALYs) were estimated for device recipients and control patients. Data on mortality, complication rates, and device longevity were retrieved from our center and entered into the Markov model. To account for model assumptions, one\u2010way deterministic and probabilistic sensitivity analyses were performed. Importantly, calculations for the estimated incremental cost\u2010effectiveness rate (ICER) per QALY gained are based on several numbers of assumptions, and accordingly findings may have over\u2010 or underestimated the cost\u2010effectiveness of ICD therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Primary prevention ICD implantation adds an estimated mean of 2.07 LYs and 1.73 QALYs. Increased lifetime cost for single\u2010chamber and dual\u2010chamber ICD recipients were estimated at \u20ac60,788 and \u20ac64,216, respectively. This resulted for single\u2010chamber ICD recipients, in an estimated ICER of \u20ac35,154 per QALY gained. In dual\u2010chamber ICD recipients, an estimated ICER of \u20ac37,111 per QALY gained was calculated. According to the probabilistic sensitivity analysis, estimated cost per QALY gained are \u20ac35,837 (95% confidence interval [CI]: \u20ac28,368\u2013\u20ac44,460) for single\u2010chamber and \u20ac37,756 (95% CI: \u20ac29,055\u2013\u20ac46,050) for dual\u2010chamber ICDs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>On the basis of data and detailed costs, derived from routine clinical practice, ICD therapy in selected patients with a reduced left ventricular ejection fraction appears to be cost\u2010effective.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.12238","type":"journal-article","created":{"date-parts":[[2013,9,2]],"date-time":"2013-09-02T19:32:27Z","timestamp":1378150347000},"page":"25-34","source":"Crossref","is-referenced-by-count":13,"title":["Cost\u2010Effectiveness of Primary Prevention Implantable Cardioverter Defibrillator Treatment: Data from a Large Clinical Registry"],"prefix":"10.1111","volume":"37","author":[{"given":"JOEP","family":"THIJSSEN","sequence":"first","affiliation":[{"name":"Department of Cardiology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. ELSKE","family":"VAN DEN AKKER VAN MARLE","sequence":"additional","affiliation":[{"name":"Department of Medical Decision Making Leiden University Medical Centre  Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. 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Cardiology"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,9,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199711273372202"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043399"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199912163412503"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.101.11.1297"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.102.7.748"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199612263352601"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa013474"},{"key":"e_1_2_6_9_1","first-page":"e350","article-title":"ACC\/AHA\/HRS 2008 Guidelines for Device\u2010Based Therapy of Cardiac Rhythm Abnormalities: A report of the American College of Cardiology\/American Heart Association Task Force on Practice 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