title: Cost-effectiveness of implantable cardioverter-defibrillator in today's world.
abstract: The implantable cardioverter-defibrillator (ICD) is an example of an effective intervention with high up-front costs and delayed benefits. It has become a proven and well-accepted therapy not only for secondary but also for primary prevention of sudden cardiac death in patients with ischemic and non-ischemic heart disease. In recent years, the international guidelines have extended the indications to the prophylactic ICD, increasing the number of eligible patients and, together, the financial challenges of a widespread implementation. In this article, we review the available economic tools that can help address the ICD cost issue. We think that the awareness of such knowledge may facilitate dialogues between physicians, administrators and policy-makers, and help foster rational decision making.
authors.affiliation: Institute of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine, University Hospital Sant' Orsola-Malpighi, Via Massarenti 9, 40138 Bologna, Italy. Electronic address: giuseppe.boriani@unibo.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Boriani
authors.affiliation: Institute of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine, University Hospital Sant' Orsola-Malpighi, Via Massarenti 9, 40138 Bologna, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Cimaglia
authors.affiliation: Institute of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine, University Hospital Sant' Orsola-Malpighi, Via Massarenti 9, 40138 Bologna, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Biffi
authors.affiliation: Institute of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine, University Hospital Sant' Orsola-Malpighi, Via Massarenti 9, 40138 Bologna, Italy.
authors.forename: Cristian
authors.initials: C
authors.lastname: Martignani
authors.affiliation: Institute of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine, University Hospital Sant' Orsola-Malpighi, Via Massarenti 9, 40138 Bologna, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Ziacchi
authors.affiliation: Institute of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine, University Hospital Sant' Orsola-Malpighi, Via Massarenti 9, 40138 Bologna, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Valzania
authors.affiliation: Institute of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine, University Hospital Sant' Orsola-Malpighi, Via Massarenti 9, 40138 Bologna, Italy.
authors.forename: Igor
authors.initials: I
authors.lastname: Diemberger
mesh_terms: D003362:Cost-Benefit Analysis; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D017147:Defibrillators, Implantable / Q000191:economics*; D006801:Humans; D011322:Primary Prevention; D019057:Quality-Adjusted Life Years
keywords: Cost-effectiveness; Costs; Heart failure; Implantable cardioverter-defibrillator; Sudden cardiac death