TY  - BOOK
AU  - Eldadah, Zayd A
TI  - Cost-Effectiveness of an Antibacterial Envelope for CIED Infection Prevention in the US Healthcare System from the WRAP-IT Trial
SN  - 1941-3084
PY  - 2020///
KW  - *Anti-Bacterial Agents/ec [Economics]
KW  - *Antibiotic Prophylaxis/ec [Economics]
KW  - *Cardiac Resynchronization Therapy Devices/ec [Economics]
KW  - *Defibrillators, Implantable/ec [Economics]
KW  - *Drug Costs
KW  - *Prosthesis Implantation/ec [Economics]
KW  - *Prosthesis-Related Infections/ec [Economics]
KW  - Absorbable Implants/ec [Economics]
KW  - Anti-Bacterial Agents/tu [Therapeutic Use]
KW  - Cardiac Resynchronization Therapy Devices/ae [Adverse Effects]
KW  - Clinical Decision-Making
KW  - Cost Savings
KW  - Cost-Benefit Analysis
KW  - Decision Trees
KW  - Defibrillators, Implantable/ae [Adverse Effects]
KW  - Humans
KW  - Models, Economic
KW  - Multicenter Studies as Topic
KW  - Prosthesis Implantation/ae [Adverse Effects]
KW  - Prosthesis Implantation/is [Instrumentation]
KW  - Prosthesis-Related Infections/mi [Microbiology]
KW  - Prosthesis-Related Infections/pc [Prevention & Control]
KW  - Quality of Life
KW  - Quality-Adjusted Life Years
KW  - Randomized Controlled Trials as Topic
KW  - Risk Factors
KW  - Time Factors
KW  - Treatment Outcome
KW  - United States
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N1  - Available online from MWHC library: 2008 - present
N2  - Background - In the WRAP-IT trial, adjunctive use of an absorbable antibacterial envelope resulted in a 40% reduction of major cardiac implantable electronic device (CIED) infection without increased risk of complication in 6,983 patients undergoing CIED revision, replacement, upgrade, or initial cardiac resynchronization therapy defibrillator (CRT-D) implant. There is limited information on the cost-effectiveness of this strategy. As a pre-specified objective, we evaluated antibacterial envelope cost-effectiveness compared to standard-of-care infection prevention strategies in the US healthcare system. Methods - A decision tree model was used to compare costs and outcomes of antibacterial envelope (TYRX) use adjunctive to standard-of-care infection prevention vs. standard-of-care alone over a lifelong time horizon. The analysis was performed from an integrated payer-provider network perspective. Infection rates, antibacterial envelope effectiveness, infection treatment costs and patterns, infection-related mortality, and utility estimates were obtained from the WRAP-IT trial. Life expectancy and long-term costs associated with device replacement, follow-up, and healthcare utilization were sourced from the literature. Costs and quality-adjusted life years (QALYs) were discounted at 3%. An upper willingness-to-pay (WTP) threshold of
UR  - https://dx.doi.org/10.1161/CIRCEP.120.008503
ER  -