Cost and efficacy analysis in the ESVEM trial: implications for diagnosis and therapy for ventricular tachyarrhythmias.
Physicians must now consider the likely cost of management decisions as well as the expected effects on patient outcome. Cost-ascertainment studies identify and contrast the cost of therapies, and cost-effectiveness analysis compares the additional cost of a therapy with its additional effect on survival and quality of life. This article reviews the principles of cost-ascertainment and cost-effectiveness analysis and then presents the cost of initial and follow-up care in Electrophysiologic Study Versus Electrocardiographic Monitoring (ESVEM) trial. Finally, the cost-effectiveness of therapy guided by electrophysiologic study or Holter monitoring and of sotalol versus other drugs is reviewed, and implications for future studies are discussed.
Hlatky
M A
MA
Division of Health Services Research, Department of Health Research and Policy, Stanford University School of Medicine, CA 94305-5092, USA.
D000319:Adrenergic beta-Antagonists / Q000191:economics / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000191:economics / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D015716:Electrocardiography, Ambulatory / Q000191:economics*; D006801:Humans; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics*; D014481:United States
D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents