Implantable devices/implantation therapy advantages

Before the era of primary implantation, ICD therapy generally used to fit in the cost-effective range of 20,000- 40,000 (136,210-213). MushUn assessed incremental cost-effectiveness of ICD implant in the MADIT trial (214). After 4 years, ICD implants were associated with an incremental benefit of 0.8 years. Based on this survival benefit, the authors estimated that ICD cost was 22,800 for the 181 patients who received a transvenous device. The cost per life year saved for ICDs in the AVID trial was > 114,917. The reason for this extraordinarily high cost is, in part due to the short-term follow-up, and the short (2.9-month) survival advantage for the ICD group despite a 37% reduction in mortality. 

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