Cost-effectiveness of implantable cardioverter-defibrillators in Brugada syndrome treatment.
Brugada syndrome is characterized by an ST-segment elevation in the right precordial ECG leads and a high incidence of sudden death in patients with structurally normal hearts. Some trials have demonstrated that the cost-effectiveness of ICD implantation treatment in patients with structurally abnormal hearts is more favorable than that of control treatment. We used Treeage pro 2005 to estimate costs and survival among the Brugada syndrome patients who received either an ICD or were treated by control therapy of Ito-blocking properties (quinidine) or beta-blockers (propranolol). In conclusion, our analysis suggests that prophylactic implantation of an ICD has good cost-effectiveness in patients with Brugada syndrome who are at high risk of sudden death. ICD treatment has shown a cost-effectiveness ratio below $9591 per QALY gained from trials of defibrillator vs beta-blockers for Unexplained Death in Thailand (DEBUT). The control therapy of quinidine may be a good choice for patients who are infants or living in developing countries.
Wang
Kai
K
Department of Medical Information and Management Science, Graduate School of Medicine, Nagoya University, 65 Tsurumai, Showa-Ku, 466-8550 Nagoya, Japan. wangkai@med.nagoya-u.ac.jp
Yamauchi
Kazunobu
K
Li
Ping
P
Kato
Hiroki
H
Kobayashi
Makoto
M
Kato
Ken
K
Shimizu
Yoshiyuki
Y
D053840:Brugada Syndrome / Q000188:drug therapy*; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D017147:Defibrillators, Implantable / Q000191:economics*; D006801:Humans; D007564:Japan; D019057:Quality-Adjusted Life Years; D016019:Survival Analysis; D013997:Time Factors