title: Cost effectiveness of cardiac resynchronization therapy in Greece: an analysis based on the CArdiac REsychronization in Heart Failure trial.
abstract: OBJECTIVE
  Health economic considerations have become increasingly important in healthcare. The aim of this study was to investigate the incremental cost effectiveness of cardiac resynchronization therapy (CRT) plus medical therapy compared with medical therapy alone in the Greek health-care system.
  
  
  RESULTS
  The health economic analysis was based on the CARE-HF trial, a randomized clinical trial estimating the efficacy of adding CRT (n = 409) to optimal pharmacological treatment (n = 404) in patients with moderate-to-severe heart failure with markers of cardiac dyssynchrony. Health care resource use from CArdiac REsychronization in Heart Failure was combined with costs for CRT implantation and hospitalization from publicly available sources. The analysis was based on a lifetime perspective, with the life expectancy estimated from the clinical trial data. Shorter time horizons were explored in the sensitivity analysis. The cost per quality-adjusted life year (QALY) gained with CRT was €6,045 in Greece, with a 95% confidence interval for the cost-effectiveness ratio of €4,292-9,411 per QALY gained.
  
  
  CONCLUSIONS
  The results of the economic evaluation of CRT in Greek health-care setting indicate that it is a cost-effective treatment compared with traditional pharmacological therapy. Cardiac resynchronization therapy can therefore be recommended for routine use in patients with moderate-to-severe heart failure and markers of dyssynchrony.
authors.affiliation: Department of Health Services Management, National School of Public Health, Athens, Greece. nmaniadakis@esdy.edu.gr
authors.forename: N
authors.initials: N
authors.lastname: Maniadakis
authors.forename: M
authors.initials: M
authors.lastname: Ekman
authors.forename: M J
authors.initials: MJ
authors.lastname: Calvert
authors.forename: N
authors.initials: N
authors.lastname: Freemantle
authors.forename: M
authors.initials: M
authors.lastname: Karamalis
authors.forename: P
authors.initials: P
authors.lastname: Vardas
mesh_terms: D058406:Cardiac Resynchronization Therapy / Q000191:economics*; D003362:Cost-Benefit Analysis; D005500:Follow-Up Studies; D006115:Greece / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data; D006333:Heart Failure / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D004364:Pharmaceutical Preparations / Q000191:economics; D019057:Quality-Adjusted Life Years; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D004364:Pharmaceutical Preparations