Clinical and cost-effectiveness analysis of drug eluting stents compared to bare metal stents for percutaneous coronary interventions in Ontario: final report
Bowen JM, Hopkins R, Chiu M, Blackhouse G, Lazzam C, Ko D, Tu JV, Cohen E, Campbell K, He Y, Willan A, Tarride J-E, Goeree R
Record ID 32008100109
English
Authors' objectives:
The objectives of the study are twofold (1) To estimate the reduction in the risk of repeat revascularization associated with the use of DES, relative to BMS, among patients at high risk of restenosis; and (2) Combining the data from the registry study with costs and other published evidence, to estimate the net cost and costeffectiveness of percutaneous coronary interventions (PCI) with DES, relative to BMS.
Authors' recommendations:
The results from the field evaluation, as found in the interim evaluation, continue to indicate that DES reduces predicted revascularization rates at 2 year compared to BMS in some but not all patient cohorts. This unique evaluation of “real-world” experience with the use of DES compared to BMS provides insight into the efficacy of DES in patients with specific baseline characteristics divided by lesion characteristics. In non Post MI patients, diabetes DES appears to be most effective in reducing the need for revascularization in patients with long or narrow lesions. DES as compared to BMS does not appear to provide a reduction in revascularization rates, after 2 years following the index PCI, in patients with short and wide lesions, in patients with and without diabetes.The economic analysis incorporating “real-world” data from over 16,000 patients in Ontario found that for the majority of cohorts that the cost-effectiveness ratio for DES compared to BMS was above $200,000/QALY. The absolute difference of approximately 12% was found in revascularization rates between the two interventions in this non-post MI, diabetes with narrow lesions.
Authors' methods:
Systematic review
Details
Project Status:
Completed
Year Published:
2007
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Canada
MeSH Terms
- Canada
- Outcome Assessment, Health Care
- Percutaneous Coronary Intervention
- Cost-Benefit Analysis
- Drug-Eluting Stents
- Stents
- Antineoplastic Agents
- Myocardial Revascularization
Contact
Organisation Name:
Medical Advisory Secretariat
Contact Address:
Medical Advisory Secretariat, 20 Dundas Street West, 10th Floor, Toronto, ON M5G 2N6 CANADA. Tel: 416-314-1092l; Fax: 416-325-2364;
Contact Name:
MASinfo.moh@ontario.ca
Contact Email:
MASinfo.moh@ontario.ca
Copyright:
Medical Advisory Secretariat, Ontario Ministry of Health and Long-Term Care (MAS)
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