Abstract
IntroductionHeart failure (HF) is an unusual heart function that causes reduction in cardiac or pulmonary output. Cardiac resynchronization therapy (CRT) is a mechanical device that helps to recover ventricular dysfunction by pacing the ventricles. This study planned to systematically review cost-effectiveness of CRT combined with an implantable cardioverter-defibrillator (ICD) versus ICD in patients with HF.MethodsWe used five databases (NHS Economic Evaluation Database, Cochrane Library, Medline, PubMed, and Scopus) to systematically reviewed studies published in the English language on the cost-effectiveness of CRT with defibrillator (CRT-D) Vs. ICD in patients with HF over 2000 to 2020. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist was applied to assess the quality of the selected studies.ResultsFive studies reporting the cost-effectiveness of CRT-D vs ICD were finally identified. The results revealed that time horizon, direct medical costs, type of model, discount rate, and sensitivity analysis obviously mentioned in almost all studies. All studies used quality-adjusted life years (QALYs) as an effectiveness measurement. The highest and the lowest Incremental cost-effectiveness ratio (ICER) were reported in the USA ($138,649per QALY) and the UK ($41,787per QALY), respectively.ConclusionResult of the study showed that CRT-D compared to ICD alone was the most cost-effective treatment in patients with HF.
Highlights
Heart failure (HF) is an unusual heart function that causes reduction in cardiac or pulmonary output
Literature search This systematic review was conducted to assess articles on the cost-effectiveness of Cardiac resynchronization therapy (CRT) combined with an implantable cardioverter-defibrillator (ICD) versus ICD alone in patients with HF between January 2000 and July 2020
We selected and evaluated the results of five studies with full economic evaluation of CRT combined with an ICD versus ICD in patients with HF [20,21,22,23,24]
Summary
Heart failure (HF) is an unusual heart function that causes reduction in cardiac or pulmonary output. Heart failure (HF) is one of the most common and deadliest disease that consumes the highest rate of health expenditure in the world [1, 2] It is a set of clinical syndromes in which abnormal cardiac function leads to a decrease in cardiac or pulmonary output or persistent. In HF patients, based on some clinical factors such as, left ventricular ejection fraction (LVEF), ischemic etiology status, QRS duration and New York Heart Association (NYHA) class, Cardiac resynchronization therapy (CRT) helps to recover ventricular dysfunction through pacing the right and left ventricles concurrently [12,13,14,15].
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