ISSN : 2146-3123
E-ISSN : 2146-3131

An Analysis of Cost-Effectiveness of Stents Used in the Treatment of Coronary Artery Disease
Ferda Işıkçelik1, İsmail Ağırbaş1, Cansın Tulunay Kaya2
1Department of Health Management, Ankara University School of Health Science, Ankara, Turkey
2Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey
DOI : 10.4274/balkanmedj.galenos.2019.2018.12.28
Pages : 276-282

Abstract

Background: There is only limited information about the cost-effectiveness of drug-eluting stents compared with bare-metal stents in Turkey.
Aims: To evaluate bare-metal and drug-eluting stents used in the treatment of coronary artery disease from the perspective of the reimbursement institution with cost-effectiveness analysis.
Study Design: Retrospective cost-effectiveness analysis.
Methods: In our study, 329 patients diagnosed with coronary artery disease and treated with bare-metal or drug-eluting stents in the cardiology clinics of a public university hospital between January 1 and December 31, 2016 were investigated. Bare-metal and drug-eluting stents used in the treatment of coronary artery disease were evaluated retrospectively with cost-effectiveness analysis from the perspective of the reimbursement institution.
Results: The cost of treatment with a bare-metal stent was 2,131.41 Turkish Liras, and the cost of treatment with a drug-eluting stent was 3,546.14 Turkish Liras; the Quality Adjusted Life Years value of treatment with a bare-metal stent was 0.8371, and the Quality Adjusted Life Years value of treatment with a drug-eluting stent was 0.8924. All these data were analyzed by decision tree. As a result of decision tree analysis, the weighted cost of treatment with a bare-metal stent was 2,340.71 Turkish Liras and weighted Quality Adjusted Life Years value was 0.8332; and the weighted cost of treatment with drug-eluting stent was 3,970.90 Turkish Liras and the weighted Quality Adjusted Life Years value of the treatment with drug-eluting stent was 0.8911. With these values, the additional cost-effectiveness ratio was calculated as 28,179.12 Turkish Liras per acquired Quality Adjusted Life Years. The additional cost-effectiveness ratio is in the first zone in the cost-effectiveness plane and below the very threshold of cost-effectiveness.
Conclusion: In our study, it was concluded that drug-eluting stents are cost effective compared with bare-metal stents in the treatment of coronary artery disease. Considering the cost and effectiveness of the drug-eluting stent, it is thought that increasing reimbursement for this technology by the reimbursement agency would be beneficial for the service provider.

Keywords : Coronary artery disease, cost-effectiveness analysis, economic evaluation, health technology assessment, stents
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