BUDGET IMPACT AND CARBON CONSEQUENCES OF WEARABLE CARDIOVERTER-DEFIBRILLATOR USE IN FRANCE: A THREE-COHORT ANALYSIS OF NON-ISCHEMIC HEART FAILURE, HEART TRANSPLANT, AND MYOCARDITIS/PPCM
Author(s)
Caroline Demeothis, PhD1, Brigitte Both, PhD2, Vladica M. Velickovic, PhD, MD3, Amara Amara, MD, PhD4, Franck Maunoury, MSc, PhD5.
1Zoll CMS, Paris, France, 2Zoll CMS GmbH, Köln, Germany, 3BIOMATH MODELS, London, United Kingdom, 4GHI Le Raincy-Montfermeil, Montfermeil, France, 5STATESIA, LE MANS, France.
1Zoll CMS, Paris, France, 2Zoll CMS GmbH, Köln, Germany, 3BIOMATH MODELS, London, United Kingdom, 4GHI Le Raincy-Montfermeil, Montfermeil, France, 5STATESIA, LE MANS, France.
OBJECTIVES: To estimate the 1-year budget impact and environmental consequences of adding a wearable cardioverter-defibrillator (WCD) to guideline-directed therapy (GDT) in France for three cohorts: non-ischemic heart failure (HF), patients awaiting heart transplant, and myocarditis/peripartum cardiomyopathy (PPCM).
METHODS: A deterministic R/Shiny budget impact model compared WCD+GDT versus GDT over 1 year from the French health system perspective. Only the three relevant cohorts from the attached run were included. Outcomes were total costs, incremental budget impact, CO2 emissions, and monetised CO2 savings. Cost categories included intervention, initial hospitalisation, monitoring, adverse events, ICD implantation, ICD-related events, cardiac arrest, and end-of-life.
RESULTS: In non-ischemic HF, WCD+GDT reduced total costs versus GDT (€85.0M vs €342.1M), generating savings of €257.0M. In heart transplant, WCD+GDT was marginally cost-saving (€4.2M vs €4.3M; savings €57,827). In myocarditis/PPCM, WCD+GDT reduced total costs (€184.1M vs €186.8M), generating savings of €2.7M. Across the three cohorts, total costs were €273.5M with WCD+GDT and €533.3M with GDT, yielding net savings of €259.8M. Savings were primarily driven by lower ICD implantation costs (€112.8M vs €258.0M) and lower ICD-related event costs (€23.5M vs €87.9M), partly offset by higher intervention costs (€48.8M vs €5.5M). CO2 emissions were 16.7M kg with WCD+GDT and 38.7M kg with GDT, corresponding to 22.0M kg CO2 averted and €5.55M in monetized carbon savings. After incorporating carbon savings, total net savings increased to €265.4M.
CONCLUSIONS: In this three-cohort French analysis, WCD+GDT was cost-saving and environmentally favorable versus GDT alone. The economic case was driven predominantly by the non-ischemic HF cohort, while heart transplant was essentially budget-neutral and myocarditis/PPCM modestly cost-saving. Environmental gains further strengthened the overall budget impact case.
METHODS: A deterministic R/Shiny budget impact model compared WCD+GDT versus GDT over 1 year from the French health system perspective. Only the three relevant cohorts from the attached run were included. Outcomes were total costs, incremental budget impact, CO2 emissions, and monetised CO2 savings. Cost categories included intervention, initial hospitalisation, monitoring, adverse events, ICD implantation, ICD-related events, cardiac arrest, and end-of-life.
RESULTS: In non-ischemic HF, WCD+GDT reduced total costs versus GDT (€85.0M vs €342.1M), generating savings of €257.0M. In heart transplant, WCD+GDT was marginally cost-saving (€4.2M vs €4.3M; savings €57,827). In myocarditis/PPCM, WCD+GDT reduced total costs (€184.1M vs €186.8M), generating savings of €2.7M. Across the three cohorts, total costs were €273.5M with WCD+GDT and €533.3M with GDT, yielding net savings of €259.8M. Savings were primarily driven by lower ICD implantation costs (€112.8M vs €258.0M) and lower ICD-related event costs (€23.5M vs €87.9M), partly offset by higher intervention costs (€48.8M vs €5.5M). CO2 emissions were 16.7M kg with WCD+GDT and 38.7M kg with GDT, corresponding to 22.0M kg CO2 averted and €5.55M in monetized carbon savings. After incorporating carbon savings, total net savings increased to €265.4M.
CONCLUSIONS: In this three-cohort French analysis, WCD+GDT was cost-saving and environmentally favorable versus GDT alone. The economic case was driven predominantly by the non-ischemic HF cohort, while heart transplant was essentially budget-neutral and myocarditis/PPCM modestly cost-saving. Environmental gains further strengthened the overall budget impact case.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE4
Topic
Economic Evaluation, Health Technology Assessment, Medical Technologies
Topic Subcategory
Budget Impact Analysis
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)