Cost-utility analysis of the use of a wearable cardioverter defibrillator (LifeVest®) versus standard of care in the prevention of sudden cardiac death in patients after myocardial infarction
Year: 2025
Type: article
Abstract: BACKGROUND: Each year, approximately 350 000 cases of out-of-hospital sudden cardiac arrest occur in Europe. The Vest Prevention of Early Sudden Death Trial (VEST) demonstrated the effectiveness and safety of the wearable cardioverter defibrillator (WCD) in preventing sudden cardiac death (SCD). Recent findings from a retrospective registry of Polish patients prescribed with the WCD further validated its efficacy in real-world settings. AIMS: To assess the cost-effectiveness of using the LifeVest® WCD compared to standard of care for preventing SCD in post-myocardial infarction patients in Poland. MATERIAL AND METHODS: Cost-effectiveness and cost-utility analyses were conducted from the perspective of the Polish public payer, the National Health Fund. A Markov model, reflecting current clinical practice, was utilized, incorporating data from the Vest Prevention of Early Sudden Death Trial, Polish healthcare costs, and health state utilities based on Polish norms. The analysis employed a lifetime horizon. One-way deterministic and probabilistic sensitivity analyses were performed to gauge parameter uncertainty. Results were compared against the official cost-effectiveness threshold in Poland. RESULTS: Sudden cardiac death prevention with WCD incurred additional costs of 51 300 PLN (12 100 EUR) compared to standard of care but resulted in gains of 0.49 life years and 0.39 quality-adjusted life years (QALYs). The incremental cost-utility ratio was 132 400 PLN/QALY (31 100 EUR/QALY), nearly 40% below the cost-effectiveness threshold. Sensitivity analyses confirmed the robustness of these findings. CONCLUSIONS: The strategy of preventing SCD through WCD usage proves to be cost-effective within the Polish healthcare context. The clinical benefits derived from WCD use justify the additional costs incurred, making it a viable option for SCD prevention in post-myocardial infarction patients in Poland.
Source: Kardiologia Polska
Authors: Przemysław Mitkowski, Maciej Sterliński, Marcin Czech, Andrzej Przybylski, Jerzy K Wranicz, Maciej Kempa, Jarosław Kaźmierczak, Marcin Michalak, Paweł Ptaszyński, Adam Sokal, Marek Gierlotka, Robert J Gil, Michał M Farkowski, Oskar Kowalski, Agnieszka Pawlak, Łukasz Szumowski, Mateusz Tajstra, Adam Witkowski, Adam Wojtaszczyk, Andrzej Ząbek, Iwona Dobrowolska, Katarzyna Młyńczak, Maciej Niewada, Dominik Golicki
Institutions: Poznan University of Medical Sciences, Institute of Cardiology, Warsaw University of Technology, Instytut Matki i Dziecka, University of Rzeszów, Medical University of Lodz, Gdańsk Medical University, Pomeranian Medical University, Medical University of Warsaw, Medical University of Silesia, Silesian Center for Heart Disease, University of Opole, National Medical Institute of the Ministry of Interior and Administration, Mossakowski Medical Research Institute, Polish Academy of Sciences, Jagiellonian University, John Paul II Hospital
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: diamond
Funder: ZOLL Medical Corporation
OpenAlex ID: W4414240859