Infection poses the greatest risk associated with cardiac implantable electronic devices (CIEDs), increasing patient morbidity, mortality, hospitalization time, and health expenditure. This article analyzes the cost-effectiveness of employing the TYRX absorbable antibacterial envelope for preventing CIED infection from the standpoint of Spain’s healthcare system. The focus of analysis in this study is a comparison of standard antibiotic prophylaxis with that alongside the TYRX Envelope, without considering infection risk. The model integrated factors such as infection prevalence, mortality data, and utility values from various studies, including REINFORCE, AdaptResponse, and WRAP-IT. Costs factored into the analyses include infection management as well as prevention strategies.
Results exhibit the TYRX antibacterial envelope as a dominant strategy in infection prevention, especially for CRT-D and ICD recipients, considering Spain’s willingness to pay threshold. The findings also indicate that this strategy is cost-effective for patients receiving PPM or CRT-P. The incremental cost-effectiveness ratio (ICER) remains under the threshold for willingness to pay across various CIEDs, which generally remains cost-effective for TYRX in the majority of sensitivity analysis simulations. The TYRX antibacterial envelope also surfaced as a dominant strategy for all CIEDs among high-risk patients.
This study serves as the first economic evaluation of TYRX use in Spain, adding novel evidence from a diverse population. Prior economic analyses conducted in different healthcare systems have consistently shown TYRX as a cost-effective measure for patients at heightened risk for device-related infections, a finding that aligns with this study. This research provides a path to understanding and maximizing the economic benefits of the TYRX antibacterial envelope within the constraints of healthcare systems with restricted resources, considering the additional cost incurred in the short term.