Using Real World Data to Estimate the Cost of Cardiac Implantable Electronic Device (CIED) Infection in a High-Risk Australian Population
Author(s)
Gabrielle Challis, BAppSc1, Michelle Hill2, Behnoosh Khalaj2, Md Shajedur Rahman Shawon, DPhil (Oxford) MMedSci MPH MBBS3, Liesl Strachan, BSc, PhD1, Kate King, .1, Louisa Jorm, PhD3.
1Medtronic, Macquarie Park, Australia, 23University of NSW, Sydney, Australia.
1Medtronic, Macquarie Park, Australia, 23University of NSW, Sydney, Australia.
OBJECTIVES: To estimate the costs associated with Cardiac implantable electronic device (CIED) infection in a high-risk patient population treated in the Australian healthcare system.
METHODS: An Australian retrospective cohort study using linked administrative data was undertaken to estimate healthcare costs for patients 18 years and over diagnosed with CIED infection. The ICD-10-AM diagnosis code T82.71 was used to identify patients with CIED infection discharged from New South Wales public and private hospitals between 1 July 2017 to 30 September 2022. Patients at high-risk of developing a CIED infection were defined according to criteria in a published randomised control trial and included patients undergoing any of: CIED generator replacement, a system upgrade with or without new leads, CIED pocket or lead revision, or an initial Cardiac Resynchronisation Therapy-Defibrillator (CRT-D) procedure. CIED infection costs were obtained from the study and included cost estimates for admitted hospital care, emergency department care, outpatient attendance, Medicare claims, ambulance transport, and certain dispensed medications in the period from 28-days before to 42-days after CIED infection-related hospitalisations.
RESULTS: The study identified 726 patients with CIED infection. Average treatment costs for all patients were $AUD77,746 per patient. Of the 726 patients, 135 (18.6%) were classified as high-risk. The average overall cost of a CIED infection in high-risk patients was $AUD122,494, compared to $AUD67,524 for those not at high-risk. High-risk status was one of several cost drivers that increased the total treatment cost. Other significant cost drivers included intensive care unit (ICU) stays over 24 hours, temporary cardiac pacing, and longer lengths of stay.
CONCLUSIONS: Our findings highlight the substantial economic burden of CIED infections within the Australian healthcare system, particularly among high-risk patients. These findings underscore the need for targeted strategies to prevent CIED infections in high-risk populations and reduce associated costs.
METHODS: An Australian retrospective cohort study using linked administrative data was undertaken to estimate healthcare costs for patients 18 years and over diagnosed with CIED infection. The ICD-10-AM diagnosis code T82.71 was used to identify patients with CIED infection discharged from New South Wales public and private hospitals between 1 July 2017 to 30 September 2022. Patients at high-risk of developing a CIED infection were defined according to criteria in a published randomised control trial and included patients undergoing any of: CIED generator replacement, a system upgrade with or without new leads, CIED pocket or lead revision, or an initial Cardiac Resynchronisation Therapy-Defibrillator (CRT-D) procedure. CIED infection costs were obtained from the study and included cost estimates for admitted hospital care, emergency department care, outpatient attendance, Medicare claims, ambulance transport, and certain dispensed medications in the period from 28-days before to 42-days after CIED infection-related hospitalisations.
RESULTS: The study identified 726 patients with CIED infection. Average treatment costs for all patients were $AUD77,746 per patient. Of the 726 patients, 135 (18.6%) were classified as high-risk. The average overall cost of a CIED infection in high-risk patients was $AUD122,494, compared to $AUD67,524 for those not at high-risk. High-risk status was one of several cost drivers that increased the total treatment cost. Other significant cost drivers included intensive care unit (ICU) stays over 24 hours, temporary cardiac pacing, and longer lengths of stay.
CONCLUSIONS: Our findings highlight the substantial economic burden of CIED infections within the Australian healthcare system, particularly among high-risk patients. These findings underscore the need for targeted strategies to prevent CIED infections in high-risk populations and reduce associated costs.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD75
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)