Real-world Cost-effectiveness of Drug-eluting Stents vs. Bare-metal Stents for Coronary Heart Disease – A Five-year Follow-up Study

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Title:	Real-world Cost-effectiveness of Drug-eluting Stents vs. Bare-metal Stents for Coronary Heart Disease – A Five-year Follow-up Study
Authors:	Cheng, Hao-Min;Chioue, Ling-Jan;Chen, Tzu-Ching;Sung, Shih-Hsien;Chen, Chen-Huan;Lang, Hui-Chu
Keywords:	Drug-eluting;stentsBare-metal;stentsCost-effectiveness;analysisHealth;insurance
Date:	2019-09-25
Issue Date:	2019-09-30T06:49:48Z (UTC)
Abstract:	Objective: To evaluate the cost-effectiveness of using drugeluting stents (DES) compared to bare-metalstents (BMS) for coronary heart disease (CHD).Data sources/study setting: Data were obtained from the National Health Insurance Longitudinal HealthInsurance Database, which contains claims data for 1,000,000 beneficiaries. The data were randomlysampled from all beneficiaries.Study design: A retrospective claims data analysis.Data collection/extraction methods: Patients with stable coronary heart disease who underwent coronarystent implantation from 2007 to 2008 were recruited and followed to the end of 2013. After a 2:1 propen-sity score matched by gender, age, stent number, and the Charlson comorbidity index (CCI), 852 patientswith 568 stents in the BMS group and 284 stents in the DES group were included. The cumulative medicalcosts for both matched groups were estimated with the Kaplan-Meier Sample Average (KMSA), and thenthe incremental cost-effectiveness ratio (ICER) was estimated.Principal findings: The ICER of DES vs. BMS was NT$ 663,000 per cardiovascular death averted and NT$238,394 per cardiovascular death or coronary event averted in five years from the insurer perspective.Conclusion: Percutaneous coronary intervention (PCI) with DES was a more cost-effective strategy thanPCI with BMS for CHD patients during the five-year follow-up
Appears in Collections:	[Department of Health Business Administration] Papers

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