Cost-Effectiveness of Drug-Eluting vs. Bare-Metal Stents in Patients with Coronary Artery Disease from the Korean National Health Insurance Database.
10.3349/ymj.2014.55.6.1533
- Author:
Soojin LEE
1
;
Kyungwon BAEK
;
Kihong CHUN
Author Information
1. Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea. ajoujkh@ajou.ac.kr
- Publication Type:Original Article ; Evaluation Studies ; Research Support, Non-U.S. Gov't
- Keywords:
Incremental cost effectiveness ratio;
drug-eluting stents;
bare-metal stents;
stent implantation
- MeSH:
Aged;
*Angioplasty, Balloon, Coronary;
Asian Continental Ancestry Group/statistics & numerical data;
Coronary Artery Disease/etiology/*therapy;
Cost-Benefit Analysis;
Drug-Eluting Stents/economics;
Female;
Humans;
Immunosuppressive Agents/administration & dosage/*economics;
Male;
Middle Aged;
Myocardial Infarction/therapy;
National Health Programs/*statistics & numerical data;
Paclitaxel/administration & dosage;
Republic of Korea/epidemiology;
Retrospective Studies;
Risk;
Sirolimus/administration & dosage;
Stents/adverse effects/*economics;
Treatment Outcome
- From:Yonsei Medical Journal
2014;55(6):1533-1541
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The aim of this study was to evaluate the cost-effectiveness of the use of drug-eluting stents (DESs), as compared with bare-metal stents (BMSs) in Korea. MATERIALS AND METHODS: A retrospective cohort study was conducted between January 2000 and December 2007. Subjects were stent-treated for the first time between 2004 and 2005, with four years of follow-up (2004-2007) (n=43674). The incremental cost-effectiveness ratio (ICER) was used to calculate the costs of DESs compared with BMSs among patients with coronary artery disease (CAD). Cost-effectiveness was assessed with effectiveness defined as a reduction in major adverse cardiac events after six months and after one, two, three, and four years. RESULTS: The total costs of a DESs were 674108 Korean won (KRW) higher than that of a BMSs at the end of the follow-up; 13635 thousand KRW per patient treated with DESs and 12960 thousand KRW per patient treated with BMSs. The ICER was 256315 per KRW/death avoided and 293090 per KRW/re-stenting avoided among the CAD patients at the end of the follow-up. CONCLUSION: The ICER for the high-risk patients was lower than that for the low-risk patients. The use of DESs is clinically more useful than the use of BMSs for CAD and myocardial infarction patients, especially for those considered to be high-risk patients in Korea.
