OBJECTIVES: Implantable cardiac defibrilators (ICD) are the only option for decreasing primary and secondary mortality depending on ventricular tachyarrhythmias. Subcutaneous implantable defibrillator (S-ICD) is a new medical device which serves similar clinical outcome as ICDs with a better safety profile. The aim of the study is to conduct cost-effectiveness analysis of S-ICD treatment in ventricular tachyarrhythmias (VT) patients who have contraindication for ICD. These patients only have medical treatment option or S-ICD for treatment of VT in Turkey.

METHODS: Clinical literature search has been conducted. An expert survey form has been prepared depending on findings of literature search to understand the possible cost of patient pathway of VT. The survey has been conducted with 3 experts who are experienced with VT treatment. A Markov based decision tree model has been conducted with 1 year each cycle and 30 cycles in total. S-ICD was compared to medical treatment for cost-effectiveness analysis.

RESULTS: The medical treatment costs were 34.656 TL per patient in total in 30 years, while S-ICD cost was calculated as 133.909 TL. However, S-ICD serves better clinical outcomes than medical treatment depending on model with 19.60 total life years and 13.85 total life years per patient in 30 years term, respectively. Depending on all these findings, S-ICD serves 17.261 TL/year ICER for cost-effectiveness analysis in VT patients.

CONCLUSIONS: S-ICD is a cost-effective treatment option compared to medical treatment in ventricular tachyarrhythmia patients depending on the analysis with the public health insurance perspective. On the other hand, S-ICD may help to reduce healthcare services cost and further analysis are needed.