Cost-Effectiveness Analyses of an Absorbable Antibacterial Envelope for Use in Patients at Increased Risk of Cardiac Implantable Electronic Device Infection in Germany, Italy, and England
| Autor: | Giuseppe Boriani, Andreas Goette, Fozia Z Ahmed, Charles Kennergren, Michelle Green, Judith Shore, Bruce L. Wilkoff, Mauro Biffi, Phuong Lien Carion, Janet M. McComb, Khaldoun G. Tarakji, David Wright, Thomas Blum |
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| Rok vydání: | 2021 |
| Předmět: |
Pacemaker
Artificial medicine.medical_specialty medicine.drug_class Cost effectiveness Cost-Benefit Analysis Antibiotics Context (language use) cardiac implantable electronic device law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine medicine Humans Infection control 030212 general & internal medicine Infection Control Cost–utility analysis antibacterial envelope business.industry 030503 health policy & services Health Policy Risk of infection Decision Trees cost-utility analysis Public Health Environmental and Occupational Health Antibiotic Prophylaxis infection Europe randomized controlled trial 0305 other medical science business Envelope (motion) |
| Zdroj: | Value in Health. 24:930-938 |
| ISSN: | 1098-3015 |
| DOI: | 10.1016/j.jval.2020.12.021 |
| Popis: | Objectives To model the cost-effectiveness of the TYRX Absorbable Antibacterial Envelope when used in patients at increased risk of cardiac implantable electronic device (CIED) infection in the context of 3 European healthcare systems: Germany, Italy, and England. Methods A decision tree model with a lifetime horizon was populated using data from the Worldwide Randomized Antibiotic Envelope Infection Prevention Trial, a large multicenter randomized controlled trial. Use of the antibacterial envelope adjunctive to standard of care was compared to standard of care infection prevention alone. Patients in the model were divided into subgroups based on presence of factors known to increase infection risk. Results The antibacterial envelope had the most favorable cost-effectiveness profile when patients had previously experienced CIED infection, had a history of immunosuppressive therapy, or had a Prevention of Arrhythmia Device Infection Trial (PADIT) score indicating high risk of infection (scores ≥6) at cost-effectiveness thresholds of €50 000 in Germany (assumed in the absence of an official threshold), €40 000 in Italy, and £30 000 in England. Probabilistic sensitivity analysis indicated that the antibacterial envelope was likely to be cost-effective in patients with other risk factors (including replacement of high power CIEDs, generator replacement with lead modification, and PADIT scores indicating intermediate risk of infection) when used with some device types and in some countries. Conclusions The absorbable antibacterial envelope was associated with cost-effectiveness ratios below European benchmarks in selected patients at increased risk of infection, suggesting the envelope provides value for European healthcare systems by reducing CIED infections. |
| Databáze: | OpenAIRE |
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