Wisløff T, Norderhaug IN, Kløøw NE, Rotevatn S, Kristiansen IS; Health Technology Assessment International. Meeting (2nd : 2005 : Rome, Italy).
Ital J Public Health. 2005; 2: 260.
Norwegian Health Services Research Centre, Postboks 7004 St.Olavs plass, Oslo,130 Norway Tel: (+47) 23255125, Fax: (+47) 23255010, E-mail: torbjorn.wisloff@nhsrc.no
Objective: To explore cost and health consequences of using drug eluting stents (DES) instead of bare metal stents (BMS) for patients with stable angina. Background: Use of DES when performing percutaneous coronary intervention (PCI) for stable angina reduces the risk of reintervention, but increases health care costs. Previous economic analyses may indicate that DES offer value for money, but the analyses have been based on limited number of clinical trials and short follow-up periods. Methods: We developed a Markov model which calculates costs and effects of the two-year follow-up of patients who receive a stent for stable angina. The model was based on meta-analyses of trials comparing DES with BMS. Results: The estimated cost per avoided reintervention was 4,500 EUR when BMS was replaced by DES, ranging from 200 EUR to 14,300 EUR in one-way sensitivity analyses. The price of a drug eluting stent would have to be reduced by 32% (from currently 1,750 EUR to 1,200 EUR ) to make the use of DES cost saving compared to BMS. The estimated cost per life year gained and quality adjusted life year gained were 111,200 EUR and 41,800 EUR , respectively. Probabilistic sensitivity analysis indicates a 9.2% probability that drug eluting stents are cost-effective if society is willing to pay 30,000 EUR for a quality adjusted life year. Conclusions: In a two-year perspective, DES resulted in greater costs than BMS with any realistic combination of model parameters. Cost-effectiveness of DES depended heavily on acquisition price of the device, risk of restenosis and rate of reintervention in routine practice.
Publication Types:
Keywords:
- Clinical Trials as Topic
- Cost-Benefit Analysis
- Health Care Costs
- Humans
- Quality-Adjusted Life Years
- Stents
- economics
- hsrmtgs
UI: 103141222
From Meeting Abstracts