As the benefits of prophylactic ICD therapy become increasingly evident, a significant increase in its use is expected. Both medical professionals and healthcare authorities have expressed concern over whether increased use of ICDs could disproportionately increase national healthcare expenditures (NHE). These concerns are mitigated by examining increased ICD therapy use within the context of total NHE costs and as it compares in cost-effectiveness with other lifesaving therapies.
In truth, even if the use of ICD therapy were to triple, it would still account for less than one half of 1% of the current total NHE.1 By 2005, a tripling of ICD usage would mean that only 0.4% of total NHE would be represented by ICD therapy.2
In fact, cost-effectiveness analyses have shown that prophylactic ICD therapy compares favorably with other lifesaving interventions. Utilizing a cost comparison including such factors as number of hospitalizations, follow-up treatments, and number of invasive procedures, several studies have determined that the cost-effectiveness of prophylactic ICD therapy is well within the currently accepted range of lifesaving technologies.3-5
One study, in fact, concluded that prophylactic ICD therapy becomes increasingly cost-effective when it is used early, as first-choice therapy in post-myocardial infarction (MI) patients with ventricular tachycardia (VT) or ventricular fibrillation (VF).5 Costs in this study were higher for the early ICD group only during the first 3 months. The early ICD group subsequently required fewer therapy changes and arrhythmia surgeries than a group initiated with other treatments.5
Using cost per life-year saved as a standard measure, ICD therapy may be as cost-effective, if not more so, than other life-saving interventions.3,4
