Evidence map›Paper›PMID 40711697›Full record

ArticlePharmacoEconomics - open2025

Cost-Effectiveness of an Insertable Cardiac Arrhythmia Monitor after Non-ST-Elevation Myocardial Infarction in the UK.

Amy Dymond, E Barker, N Tsitiridis, A Schmetz, S Thompson Hilpert, C Jøns, S Behrens, P Søgaard, W Green

Abstract read
In one paragraph

Article in PharmacoEconomics - open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Amy DymondYork Health Economics Consortium, York, UK. amy.dymond@york.ac.uk.ORCID http://orcid.org/0000-0002-8519-6537
E BarkerYork Health Economics Consortium, York, UK.
N TsitiridisBIOTRONIK SE & Co. KG, Berlin, Germany.ORCID http://orcid.org/0000-0002-6451-8381
A SchmetzBIOTRONIK SE & Co. KG, Berlin, Germany.
S Thompson HilpertBIOTRONIK SE & Co. KG, Berlin, Germany.ORCID http://orcid.org/0000-0001-5571-0147
C JønsRigshospitalet, Copenhagen, Denmark.ORCID http://orcid.org/0000-0002-1876-2623
S BehrensVivantes Netzwerk für Gesundheit, Berlin, Germany.ORCID http://orcid.org/0000-0002-7233-2296
P SøgaardAalborg University Hospital, Aalborg, Denmark.ORCID http://orcid.org/0000-0002-7441-0630
W GreenYork Health Economics Consortium, York, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesPatients surviving a non-ST-elevation myocardial infarction (NSTEMI) have an elevated risk of future major adverse cardiovascular events (MACE), which can be mitigated through long-term cardiac arrhythmia monitoring. The present study evaluated the cost-effectiveness of continuous remote arrhythmia monitoring using an insertable cardiac monitor (ICM) combined with standard of care (SoC) compared with SoC alone.

methodsA cost-effectiveness analysis using a lifetime partitioned survival model was developed for high-risk NSTEMI patients from a UK National Health Service (NHS) perspective. Survival analysis was used to determine the transition of patients from the pre-MACE health state (where patients could experience arrhythmia, major bleeding, or systemic embolism) to the MACE health state (worsening heart failure, stroke, and acute coronary syndrome events). The survival analysis and arrhythmia diagnosis rates were informed by the BIO|GUARD-MI trial. The model captured direct costs associated with each MACE and implantation and removal of the ICM device and treatment costs following arrhythmia detection. The model captured the health implications for an ICM with SoC, compared with SoC alone, in terms of the total quality-adjusted life years (QALYs). Deterministic and probabilistic sensitivity analyses were undertaken to explore the impact of parameter uncertainty on the model results.

resultsThe use of ICMs plus SoC for daily remote cardiac arrhythmia monitoring is cost effective, when compared with SoC alone, in high-risk NSTEMI patients over a lifetime horizon, with an incremental cost-effectiveness ratio of £7766 per QALY gained. The ICM was associated with an additional 0.184 QALYs per patient for an additional cost of £1430. The ICM remained cost effective during the deterministic and probabilistic sensitivity analyses.

conclusionThe addition of an ICM to SoC in high-risk NSTEMI patients is cost effective from the perspective of the UK NHS and would, therefore, be a further option for the management of such patients in clinical practice.

Identifiers

PMID40711697
PMCPMC12401856

What Socratic holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.