Is combined resynchronisation and implantable defibrillator therapy a cost-effective option for left ventricular dysfunction? Mary Bond, Stuart Mealing,

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Is combined resynchronisation and implantable defibrillator therapy a cost-effective option for left ventricular dysfunction? Mary Bond, Stuart Mealing, Rob Anderson, John Dean, Ken Stein, Rod S. Taylor International Journal of Cardiology Volume 137, Issue 3, Pages 206-215 (November 2009) DOI: 10.1016/j.ijcard.2008.05.073 Copyright © 2008 Elsevier Ireland Ltd Terms and Conditions

Fig. 1 Structure of the decision analytic model. Legend: Transition to any individual state resulting from either an adverse event or operation. Transition to any individual state within a submodel to an individual state. Transition from an individual state to any state within a submodel. International Journal of Cardiology 2009 137, 206-215DOI: (10.1016/j.ijcard.2008.05.073) Copyright © 2008 Elsevier Ireland Ltd Terms and Conditions

Fig. 2 a. Distribution of incremental costs versus incremental outcomes for CRT versus medical therapy. Solid line indicates a willingness to pay threshold of £30,000/QALY. b. Cost-effectiveness acceptability curves for CRT versus medical therapy. The descending curve represents medical therapy and the ascending curve CRT. International Journal of Cardiology 2009 137, 206-215DOI: (10.1016/j.ijcard.2008.05.073) Copyright © 2008 Elsevier Ireland Ltd Terms and Conditions

Fig. 3 a. Distribution of incremental costs versus incremental outcomes for CRT–ICD versus CRT. The solid line indicates a willingness to pay threshold of £30,000/QALY. b. Distribution of incremental costs versus incremental outcomes for CRT–ICD versus CRT. The descending curve represents CRT and the ascending curve CRT–ICD. International Journal of Cardiology 2009 137, 206-215DOI: (10.1016/j.ijcard.2008.05.073) Copyright © 2008 Elsevier Ireland Ltd Terms and Conditions

Fig. 4 Cost-effectiveness frontier of medical therapy versus CRT versus CRT–ICD. The left descending curve represents medical therapy; the central curve CRT and the right ascending curve CRT–ICD. International Journal of Cardiology 2009 137, 206-215DOI: (10.1016/j.ijcard.2008.05.073) Copyright © 2008 Elsevier Ireland Ltd Terms and Conditions

Fig. 5 a. Threshold analysis of CRT–ICD versus CRT cost-effectiveness and risk of sudden cardiac death at implant. b. Threshold analysis of CRT–ICD versus CRT cost-effectiveness and age at time of implant. International Journal of Cardiology 2009 137, 206-215DOI: (10.1016/j.ijcard.2008.05.073) Copyright © 2008 Elsevier Ireland Ltd Terms and Conditions