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- Title
Cost‐effectiveness analysis of biodegradable polymer versus durable polymer drug‐eluting stents incorporating real‐world evidence.
- Authors
Teng, Monica; Zhao, Ying Jiao; Khoo, Ai Leng; Ananthakrishna, Rajiv; Yeo, Tiong Cheng; Lim, Boon Peng; Chan, Mark Y.; Loh, Joshua P.
- Abstract
Summary: Aim: Compared with second‐generation durable polymer drug‐eluting stents (DP‐DES), the cost‐effectiveness of biodegradable polymer drug‐eluting stents (BP‐DES) remains unclear in the real‐world setting. We assessed the cost‐effectiveness of BP‐DES in patients with coronary artery disease undergoing percutaneous coronary intervention (PCI). Methods: We developed a decision‐analytic model to compare the cost‐effectiveness of BP‐DES to DP‐DES over 1 year and 5 years from healthcare payer perspective. Relative treatment effects during the first year post‐PCI were obtained from a real‐world population analysis while clinical event risks in the subsequent 4 years were derived from a meta‐analysis of published studies. Results: At 1 year, based on the clinical data analysis of 497 propensity‐score matched pairs of patients, BP‐DES were associated with an incremental cost‐effectiveness ratio (ICER) of USD20 503 per quality‐adjusted life‐year (QALY) gained. At 5 years, BP‐DES yielded an ICER of USD4062 per QALY gained. At the willingness‐to‐pay threshold of USD50 400 (one gross domestic product per capita in Singapore in 2015), BP‐DES were cost‐effective. Sensitivity analysis showed that the cost of stents had a significant impact on the cost‐effectiveness of BP‐DES. Threshold analysis demonstrated that if the cost difference between BP‐DES and DP‐DES exceeded USD493, BP‐DES would not be cost‐effective in patients with 1 year of follow‐up. Conclusions: Biodegradable polymer drug‐eluting stents were cost‐effective compared with DP‐DES in patients with coronary artery disease at 1 year and 5 years after PCI. It is worth noting that the cost of stents had a significant impact on the findings.
- Subjects
BIODEGRADABLE materials; MEDICAL care; PERCUTANEOUS coronary intervention; CORONARY disease; DATA analysis
- Publication
Cardiovascular Therapeutics, 2018, Vol 36, Issue 5, p1
- ISSN
1755-5914
- Publication type
Article
- DOI
10.1111/1755-5922.12442