Adult ; Aged ; Aged, 80 and over ; Female ; Hospital Costs ; Humans ; Intestinal Obstruction ; surgery ; Male ; Middle Aged ; Postoperative Complications ; Stents ; adverse effects ; economics

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.
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