Economic Evaluation of the Use of Drug-Eluting Stents versus bare-metal stents in adults with ischemic cardiomyopathy requiring angioplasty

Autores: González Díaz Belinda, Garduño Espinosa Juan, Salinas Escudero Guillermo, Reyes López Alfonso, Granados García Víctor M

Resumen

Background: The value of drug-eluting stents in preventing cardiovascular events has not been investigated in Mexico. Objective: To conduct a cost-effectiveness analysis of early and new-generation drug-eluting stents from the perspective of a healthcare provider. Methods: We conducted a cost-effectiveness analysis of early and new-generation drug-eluting stents in patients with ischemic cardiomyopathy attending a Cardiology Hospital of the Mexican Social Security Institute. The health endpoint used was major acute cardiovascular events prevented. The effectiveness by stent type was obtained from the literature. A retrospective chart review study was conducted to collect cost data on cardiovascular events including seven cost categories. Average and incremental cost effectiveness ratios were estimated. Deterministic and probabilistic sensitivity analyses were performed to test the robustness of estimates. Results: Incremental cost-effectiveness ratios in base-case were 28,910 and US$ 35,590 for early and new-generation stents, respectively. In an optimal scenario, incremental-cost effectiveness ratio was 24,776 and US$ 25,262 for early and new stents, respectively. Probabilistic sensitivity analysis suggested that 90% of cases were cost-effective when willingness-to-pay was 58,000 and US$ 66,000 for early and new-generation stents, respectively. Conclusions: The cost-effectiveness ratios of early and new-generation stents were significantly higher than corresponding bare-metal stents.

Palabras clave: Cost effectiveness bare-metal stent drug-eluting stent social security angioplasty.

2016-04-18   |   221 visitas   |   Evalua este artículo 0 valoraciones

Vol. 67 Núm.4. Julio-Agosto 2015 Pags. 219-226 Rev Invest Clin 2015; 67(4 ENGLISH)