Cost-Effectiveness of Cardioverter-Defibrillator Implantation in Kazakhstan

Figures & data

Table 1 Input Parameters of the Model

Model Parameters	Values for the Main Scenario	Standard Error	Distribution
Sudden cardiac death	0.0015	0.0001	Beta
Death from heart causes	0.0029	0.0002	Beta
Death from other causes	0.0004	0.000002	Beta
Death due to unspecified reasons	0.0024	0.0002	Beta
Sudden cardiac death	0.0042	0.0004	Beta
Death from heart causes	0.0029	0.0003	Beta
Death from other causes	0.0002	0.00002	Beta
Death due to unspecified reasons	0.0031	0.0003	Beta
Annual utility rate for patients with heart failure	0.837	0.007	Beta
Complication of ICD	0.7408	0.0112	Beta
ICD implantation	6589.831^₸	–	–
Replacing ICD	1674.516^₸	–	–
Implantation/Replacement of ICD electrodes	609 820 ^₸	–	–
Infection and inflammatory response associated with ICD	69.754 ^₸	–	–
Removing an ICD	192 018 ^₸	–	–
ICD shock discharge	5.852 ^₸	–	–
Outpatient monthly costs	2.950 ^₸	–	–
Inpatient monthly costs	14.559 ^₸	–	–
Discount rate	3.5%	–	–

Abbreviations: ICD, implantable cardioverter-defibrillator; ₸, tenge.

Figure 1 Graphic representation of the model.

Abbreviations: ICD, implantable cardioverter-defibrillator; PP, primary prevention; SCD, sudden cardiac death.

Table 2 Results of the Main Scenario

No Discounting	ICD	Control
Expenses	9554.917^₸	3458.218^₸
Incremental costs	6096.698^₸
Efficiency (Life Year Saved)	9.82	7.36
Incremental efficiency (life year saved)	2.45
ICER (Cost per Life Year Saved)	2487.362^₸
Efficiency (stored QALY)	7.16	5.39
Incremental efficiency (stored QALY)	1.77
ICER (Cost per stored QALY)	3436.156^₸
Discounted	ICD	Control
Expenses	8903.786^₸	3194.414^₸
Incremental costs	5709.372^₸
Efficiency (Life Year Saved)	8.88	6.80
Incremental efficiency (life year saved)	2.08
ICER (Cost per Life Year Saved)	2744.214^₸
Efficiency (stored QALY)	6.48	4.98
Incremental efficiency (stored QALY)	1.51
ICER (Cost per stored QALY)	3791.604^₸

Abbreviations: ICD, implantable cardioverter-defibrillator; ₸, tenge; ICER, incremental cost-effectiveness ratio; QALY, quality-adjusted life year.

Figure 2 Results of sensitivity analysis.

Abbreviations: QALYs, quality-adjusted life year; KZT, Kazakh tenge.

Data Sharing Statement

Materials and these articles are with the authors.