Institute of Social Medicine and Epidemiology, University of Lübeck, Germany.
Heart Center Leipzig, University of Leipzig, Germany.
Ger Med Sci. 2022 Mar 4;20:Doc02. doi: 10.3205/000304. eCollection 2022.
This study investigates the runtime and costs of biventricular defibrillators (CRT-D) and biventricular pacemakers (CRT-P). Accurate estimates of cardiac resynchronization therapy (CRT) device runtime across all manufactures are rare, especially for CRT-P. Health claims data of a large nationwide German health insurance was used to analyze CRT device runtime. We defined device runtime as the time between the date of implantation and the date of generator change or removal. The median costs for implantation, change, and removal of a CRT device were calculated accordingly. In total, the data set comprises 17,826 patients. A total of 4,296 complete runtimes for CRT-D devices and 429 complete runtimes for CRT-P devices were observed. Median device runtime was 6.04 years for CRT-D devices and 8.16 years for CRT-P devices (log-rank test p<0.0001). The median cost of implantation for a CRT-D device was 14,270 EUR, and for a CRT-P device 9,349 EUR. Compared to CRT-P devices, CRT-D devices had a significantly shorter device runtime of about two years. Moreover, CRT-D devices were associated with higher cost. The study provides important findings that can be utilized by cost-effectiveness analyses.
这项研究调查了双心室除颤器（CRT-D）和双心室起搏器（CRT-P）的运行时间和成本。准确估计所有制造商的心脏再同步治疗（CRT）设备的运行时间非常罕见，尤其是对于 CRT-P。使用大型全国性德国健康保险的健康索赔数据来分析 CRT 设备的运行时间。我们将设备运行时间定义为植入日期和发电机更换或移除日期之间的时间。相应地计算了 CRT 设备植入、更换和移除的中位数成本。 数据集共包含 17826 名患者。共观察到 4296 个 CRT-D 设备的完整运行时间和 429 个 CRT-P 设备的完整运行时间。CRT-D 设备的中位设备运行时间为 6.04 年，CRT-P 设备的中位设备运行时间为 8.16 年（对数秩检验 p<0.0001）。CRT-D 设备植入的中位数成本为 14270 欧元，而 CRT-P 设备为 9349 欧元。 与 CRT-P 设备相比，CRT-D 设备的设备运行时间明显缩短了约两年。此外，CRT-D 设备的成本更高。该研究提供了重要的发现，可以为成本效益分析提供依据。
