Implant rates of cardiac implantable electrical devices in Europe: A systematic literature review

Valzania, Cinzia; Torbica, Aleksandra; Tarricone, Rosanna; Leyva, Francisco; Boriani, Giuseppe

doi:10.1016/j.healthpol.2015.11.001

Cited by 49 publications

(39 citation statements)

References 58 publications

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“…Extensive empirical evidence shows that access to different types of medical technologies varies across countries and within countries (Willeme & Dumont, ; Bech et al ., ). Large differences in implant rates have been documented for cardiac implantable electrical devices (CIEDs) despite their established and internationally recognized efficacy for the management of arrhythmias (Valzania et al ., ). Studies of trends in CIED implants have shown rates consistently rising over time in virtually all countries.…”

Section: Introductionmentioning

confidence: 97%

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Investigating Regional Variation of Cardiac Implantable Electrical Device Implant Rates in European Healthcare Systems: What Drives Differences?

et al. 2017

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Despite established efficacy for cardiac implantable electrical devices (CIEDs), large differences in CIED implant rates have been documented across and within countries. The aim of this paper is to investigate the influence of socio-economic, epidemiological and supply side factors on CIED implant rates across 57 Regions in 5 EU countries and to assess the feasibility of using administrative data for this purpose. A total of 1 330 098 hospitalizations for CIED procedures extracted from hospital discharge databases in Austria, England, Germany, Italy and Slovenia from 2008 to 2012 was used in the analysis. Higher levels of tertiary education among the labour force and percent of aged population are positively associated with implant rates of CIED. Regional per capita GDP and number of implanting centres appear to have no significant effect. Institutional factors are shown to be important for the diffusion of CIED. Wide variation in CIED implant rates across and within five EU countries is undeniable. However, regional factors play a limited part in explaining these differences with few exceptions. Administrative databases are a valuable source of data for investigating the diffusion of medical technologies, while the choice of appropriate modelling strategy is crucial in identifying the drivers for variation across countries.

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Section: Introductionmentioning

confidence: 97%

“…Studies of trends in CIED implants have shown rates consistently rising over time in virtually all countries. However, these rising trends have not brought implant rates in various countries to similar levels, but quite contrarily, the differences have persisted and, in some cases, even increased (Arribas et al ., ; Valzania et al ., ).…”

Section: Introductionmentioning

confidence: 97%

Investigating Regional Variation of Cardiac Implantable Electrical Device Implant Rates in European Healthcare Systems: What Drives Differences?

et al. 2017

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“…Through the analysis of national/local guidelines and data from registries and administrative databases, rates of utilization were mapped to provide evidence of different degrees of access within member states, and whether this adoption is in line with the existing evidence on clinical and cost effectiveness. Valzania et al () reported a systematic review of the literature on implant rates for cardiac implantable electrical devices (CIEDs) in Europe. They found that there had been a recent rise in implant rates, with large geographic differences.…”

Section: Geographical Variation In the Use Of Medical Devices In The Eumentioning

confidence: 99%

Challenges in the Assessment of Medical Devices: The MedtecHTA Project

2017

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Assessing medical devices (MDs) raises challenges which require us to reflect on whether current methods are adequate. Major features of devices are: (i) device-operator interaction can generate learning curve effects; (ii) incremental nature of innovation needs to be addressed by careful identification of the alternatives for comparative and incremental costeffectiveness analysis; and (iii) broader organizational impact in terms of training and infrastructure, coupled with dynamic pricing, requires a more flexible approach to costing.The objective of the MedtecHTA project was to investigate improvements in HTA methods to allow for more comprehensive evaluation of MDs. It consisted of several work packages concerning (i) the available evidence on the currently adopted approaches for regulation and HTA of medical devices; (ii) the geographical variation in access to MDs; (iii) the development of methodological frameworks for conducting comparative effectiveness research and economic evaluation of MDs; and (iv) the organizational impact of MDs.This introductory paper summarizes the main results of the project and draws out the main overarching themes. This supplement represents a comprehensive report of all the main findings of the MedtecHTA project, and it is intended to be the main source for researchers and policy makers wanting information on the project.

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“…Cardiac resynchronization therapy (CRT) is an effective electrical treatment for selected patients with heart failure and wide QRS interval that, following the pioneering experiences performed in France around 20 years ago, obtained full development and clinical validation, moving from a compassionate treatment used in a few cases as a ‘last resort’ option, to a treatment tested and validated in randomized controlled trials (RCTs), both in the setting of moderate–severe heart failure and of mild heart failure with reduced ejection fraction . The implementation of CRT across Europe is variable, fluctuating considerably in implant rates within and across countries, as a result of the influence of different types of health care systems, as well as of different economic, demographic and cultural contexts …”

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confidence: 99%

Cardiac resynchronization therapy in the real world: need to upgrade outcome research

Boriani

Diemberger

2018

European J of Heart Fail

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Implant rates of cardiac implantable electrical devices in Europe: A systematic literature review

Cited by 49 publications

References 58 publications

Investigating Regional Variation of Cardiac Implantable Electrical Device Implant Rates in European Healthcare Systems: What Drives Differences?

Investigating Regional Variation of Cardiac Implantable Electrical Device Implant Rates in European Healthcare Systems: What Drives Differences?

Challenges in the Assessment of Medical Devices: The MedtecHTA Project

Cardiac resynchronization therapy in the real world: need to upgrade outcome research

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