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Economic impact of introducing TYRX amongst patients with heart failure and reduced ejection fraction undergoing implanted cardiac device procedures: a retrospective model based cost analysis
Authors:Emma Burnhope  Yael Rodriguez-Guadarrama  Michael Waring  Andrew Guilder  Bharti Malhotra  Reza Razavi
Institution:1. School of Biomedical Engineering and Imaging Sciences, Rayne Institute, Kings College London, London, UK;2. Cardiology, Guy’s and St Thomas Hospital, London, UK;3. Health Informatics, Guy’s and St Thomas NHS Foundation Trust, London, UK;4. TOHETI, Kings College London, London, UK;5. TOHETI, Guys and St. Thomas Hospital, London, UK;6. Vice President, Kings College London, London, UK
Abstract:Background and aims: Infection is a serious and expensive complication of Cardiac Implantable Electronic Device (CIED) procedures. A retrospective based cost analysis was performed to estimate Trust level savings of using the TYRX antibacterial envelope as a primary prevention measure against infection in a tertiary referral centre in South London, UK.

Methods: A retrospective cohort of heart failure patients with reduced ejection fraction undergoing Implantable Cardioverter Defibrillator (ICD) or Cardiac Resynchronization Therapy (CRT) procedures were evaluated. Decision-analytic modelling was performed to determine economic savings of using the envelope during CIED procedure vs CIED procedure alone.

Results: Over a 12?month follow-up period following CIED procedure, the observed infection rate was 3.14% (n?=?5/159). The average cost of a CIED infection inpatient admission was £41,820 and, further to economic analysis, the additional costs attributable to infection was calculated at £62,213.94. A cost saving of £624 per patient by using TYRX during CIED procedure as a primary preventative measure against infection was estimated.

Conclusions: TYRX would be a cost-saving treatment option amongst heart failure patients undergoing ICD and CRT device procedures based on analysis in the local geographical area of South London. If upscaled to the UK population, we estimate potential cost savings for the National Health Service (NHS).
Keywords:Infection  cardiac implantable electronic device  healthcare costs  economic model  TYRX envelope
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