Cost-Effectiveness of Drug-Eluting vs. Bare-Metal Stents in Patients with Coronary Artery Disease from the Korean National Health Insurance Database
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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 January2000 and December 2007. Subjects were stent-treated for the first time between2004 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-effectivenesswas 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 clinicallymore useful than the use of BMSs for CAD and myocardial infarction patients,especially for those considered to be high-risk patients in Korea.
Abstract
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 January2000 and December 2007. Subjects were stent-treated for the first time between2004 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-effectivenesswas 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 clinicallymore useful than the use of BMSs for CAD and myocardial infarction patients,especially for those considered to be high-risk patients in Korea.
참고문헌 (18)
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