title: Cost-of-illness study of patients subjected to cardiac rhythm management devices implantation: results from a single tertiary centre.
abstract: OBJECTIVE
  The aim of the present study is to estimate the procedure (implantation) cost, the total hospitalization cost and annual follow-up cost, in patients subjected to pacemaker (PM) and implantable cardioverter-defibrillator (ICD) implantation.
  
  
  RESULTS
  A single-center, prospective, cost-of-illness study was conducted between August 2008 and July 2009. In total, 464 consecutive patients were recruited (370 were subjected to PM implantation and 94 to ICD implantation). Resource data were assessed at patients' enrolment in the study and at 6th and 12th months of patients' follow-up. Then, the procedure cost, the total hospitalization cost as well as the annual patients' follow up costs were calculated using a bottom-up approach. The mean (95% confidence interval) procedure cost of PM and ICD implantation (including the costs of devices, electrodes, other supplies, and personnel's time) was calculated to be €1803 (€1758-€1858) and €13,521 (€13,153-€13,892), respectively. The mean total hospitalization cost (including procedure cost, hospitalization cost, cost of laboratory and imaging diagnostic examinations and the indirect cost attributed to productivity lost due to patient's hospitalization) was €3926 (€3711-€4167) for PM and €17,764 (€16,852-€18,692) for ICD. The mean annual cost (direct and indirect) was €1816 (€1433-€2421) for PM and €2819 (€2115-€3703) for ICD. No difference was detected in the annual cost between patients with initial implantation and replacement.
  
  
  CONCLUSIONS
  These data revealed that although these devices are associated with a relatively high upfront cost, the annual societal cost following the implantation is low. Therefore, implantation of such devices should be encouraged since these devices reduce the morbidity and mortality without a high economic burden to society.
authors.affiliation: Department of Cardiology, Heraklion University Hospital, PO Box 1352 Stavrakia, Heraklion, Crete 711 10, Greece. jfanourgiakis@yahoo.com
authors.forename: John
authors.initials: J
authors.lastname: Fanourgiakis
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Simantirakis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Maniadakis
authors.forename: Georgia
authors.initials: G
authors.lastname: Kourlaba
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Kanoupakis
authors.forename: Stavros
authors.initials: S
authors.lastname: Chrysostomakis
authors.forename: Panos
authors.initials: P
authors.lastname: Vardas
mesh_terms: D000041:Absenteeism; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics; D001145:Arrhythmias, Cardiac / Q000191:economics* / Q000628:therapy*; D002304:Cardiac Pacing, Artificial / Q000191:economics*; D016009:Chi-Square Distribution; D003266:Continuity of Patient Care / Q000191:economics; D017046:Cost Savings; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D017147:Defibrillators, Implantable / Q000191:economics*; D003952:Diagnostic Imaging / Q000191:economics; D016527:Drug Costs; D004554:Electric Countershock / Q000191:economics* / Q000295:instrumentation; D005260:Female; D006115:Greece; D017721:Hospital Costs; D006785:Hospitals, University / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D010138:Pacemaker, Artificial / Q000191:economics*; D011446:Prospective Studies; D062606:Tertiary Care Centers / Q000191:economics*; D013997:Time Factors; D016896:Treatment Outcome