Table 1 Cost-effectiveness study characteristics
No. | Author | Country and year | Study model | Population | Comparators | Effectiveness measure | Time horizon | Study perspective | Included cost | Sensitivity analyses | Discount rate for cost and effectiveness | ICER (standardized value) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | Dhvani Shah et al. [24] | USA, 2020 | Cohort survival model | N = 12,638 Randomized clinical data real world evidence ( RWE), 4 NYHA classs, 3 QRS categories (< 120 ms, ≥ 120 ms/< 150 ms, ≥ 150 ms), 4 LVEF categories (≤ 20, > 20 & ≤ 25, > 25 and ≤ 30, > 30), 2 Etiology (ischemic/non-ischemic) | CRT-D vs ICD | Life years (LY), QALY | Life time | US payer | Direct medical cost | Deterministic, probabilistic | 3% | The incremental cost-effectiveness ratio of CRT-ICD compared to ICD was $100,000/QALY ($100,000/QALY) |
2 | Mealing et al. [22] | UK, 2016 | Decision | N=12,638 A typical UK HFrEF, pateints aged 66 years or older, all NYHA classes and LVEF ≤ 35%, 1 etiology (ischemic) | ICD vs CRT-D, CRT-P | QALY | Life time | NHS | Direct medical Cost | Deterministic | 3.5% | At a threshold of £30 000 per QALY gained, CRT-D is cost-effective ($41,787/QALY) |
3 | Woo et al. [20] | USA, 2015 | Markov decision | N/A Patients aged 65 years or older, NYHA classes I or II, QRS of 12 msec or more, LVEF of 30% or less, 2 etiology (ischemic/non-ischemic) | CRT-D vs ICD | Life years (LY), QALY | Life time | Societal | Direct medical cost | Deterministic | 3% | ICER increased to $119,600 per QALY ($138,649/QALY) |
4 | Bertoldi et al. [23] | Brazil, 2013 | Markov | N=316 Hypothetical cohort of heart failure, NYHA class II, III or IV, prolonged QRS and LVEF ≤35%, etiology(NA) | CRT-D vs ICD, CRT-P | QALY | 20 years | Brazilian public health system | Direct medical cost | Deterministic, probabilistic | 5% | For CRT combined with an implantable cardioverter–defibrillator (ICD), ICER was Into $ 36,940/QALY over ICD alone ($45,431/QALY) |
5 | Noys et al. [21] | USA, 2013 | No model | N=1271 (MADIT-CRT) trial, NYHA classes I or II, QRS of 130 msec or more and LVEF of 30% or less,2 etiology (ischemic/non-ischemic) | CRT-D vs ICD | Life years(LY), QALY | 4 year follow-up | Third-party payer | Direct medical cost | Deterministic, probabilistic | 3% | The incremental cost-effectiveness ratio of CRT-ICD compared to ICD was $58,330/quality adjusted life years(QALY) ($71,738/QALY) |