Economic evaluation of an absorbable antibiotic envelope for prevention of cardiac implantable electronic device infection.

摘要: Aims Recent evidence suggests that an antibiotic impregnated envelope inserted at time of cardiac implantable electronic device (CIED) implantation may reduce risk subsequent CIED infection compared with standard care (SoC). The objective the current work was to perform a cost-effectiveness analysis comparing SoC insertion. Methods and results Decision analytic models were used project healthcare costs benefits two strategies, plus (Env+SoC) vs. alone, in cohort patients undergoing over 1-year horizon. Evidence from published literature informed model inputs. Probabilistic deterministic sensitivity analyses performed. primary outcome incremental cost per prevented, assessed Canadian system perspective. Envelope associated fewer (7 infections/1000 patients) higher total ($29 033 000/1000 (11 infections $27 926 patients). prevented 1 year $274 416. Use Env+SoC saving only when baseline increased 6% (vs. base case 1.2%). Conclusions A strategy not economically favourable opportunity widescale implementation should be considered. Future is required develop validated stratification tools identify greatest infection. value proposition improves applying this intervention risk.