Economic analysis of drug-eluting coronary stents in Brazil: a choice for all or just for a few patients?

Rassi, Anis

doi:10.1590/s0066-782x2007000400001

Cited by 7 publications

(4 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The two periodicals had some sections in common, such as Editorial, Original Articles, Review Articles, Case Reports and Letters to the Editor, but in different proportions: for example, Arquivos Brasileiros de Cardiologia only published one editorial. 7 However, there were also some sections that were peculiar to each journal. For example, Arquivos Brasileiros de Cardiologia presented the following sections: Anatomopathological Session ( sic ), Clinical Radiological Session ( sic ), Brief Comments, In Memoriam, Point of View, Image, Clinical Update and Guideline.…”

Section: Discussionmentioning

confidence: 99%

Methodological adequacy of articles published in two open-access Brazilian cardiology periodicals

2010

View full text Add to dashboard Cite

CONTEXT AND OBJECTIVE: The use of rigorous scientific methods has contributed towards developing scientific articles of excellent methodological quality.This has made it possible to promote their citation and increase the impact factor. Brazilian periodicals have had to adapt to certain quality standards demanded by these indexing organizations, such as the content and the number of original articles published in each issue. This study aimed to evaluate the methodological adequacy of two Brazilian periodicals within the field of cardiology that are indexed in several databases and freely accessible through the Scientific Electronic Library Online (SciELO), and which are now indexed by the Web of Science (Institute for Scientific Information, ISI). DESIGN AND SETTING:Descriptive study at Brazilian Cochrane Center. METHODS:All the published articles were evaluated according to merit assessment (content) and form assessment (performance).RESULTS: Ninety-six percent of the articles analyzed presented study designs that were adequate for answering the objectives.CONCLUSIONS: These two Brazilian periodicals within the field of cardiology published methodologically adequate articles, since they followed the quality standards. Thus, these periodicals can be considered both for consultation and as vehicles for publishing future articles. For further analyses, it is essential to apply other indicators of scientific activity such as bibliometrics, which evaluates quantitative aspects of the production, dissemination and use of information, and scientometrics, which is also concerned with the development of science policies, within which it is often superimposed on bibliometrics.RESUMO CONTEXTO E OBJETIVO: A utilização de métodos científicos rigorosos tem contribuído para o desenvolvimento de artigos científicos de excelente qualidade metodológica, o que permite a promoção da sua citação, bem como o aumento do fator de impacto. Os periódicos nacionais tiveram que se adequar a alguns padrões de qualidade exigidos pelos indexadores, como por exemplo o conteúdo e o número de artigos originais publicados em cada fascículo. O objetivo foi avaliar a adequação metodológica de dois periódicos brasileiros, na área de cardiologia, indexados em várias bases de dados e disponíveis em livre acesso na Scientific Electronic Library Online (SciELO) e atualmente indexados na Web of Science (Institute for Scientific Information, ISI). TIPO DE ESTUDO E LOCAL: Estudo descritivo realizado no Centro Cochrane do Brasil.MÉTODO: Todos os artigos foram avaliados quanto ao mérito (conteúdo) e quanto à forma (desempenho).RESULTADO: Foi observada uma taxa de 96% de adequação metodológica entre os artigos avaliados, que apresentaram desenho de estudo adequado para responder o objetivo proposto.CONCLUSÕES: Esses dois periódicos brasileiros na área da cardiologia publicaram artigos metodologicamente adequados, considerando os critérios de qualidade utilizados. Assim, esses periódicos podem ser considerados para consulta e como veículos para a publ...

show abstract

Section: Discussionmentioning

confidence: 99%

Methodological adequacy of articles published in two open-access Brazilian cardiology periodicals

2010

View full text Add to dashboard Cite

show abstract

“…8 Regarding BMS, the following question must be asked: what is the additional cost for each new averted revascularisation? In Brazil, the values obtained in order to avoid either a new revascularisation or an event in the target vessel were R$ 47,000 in the analysis by Polanczyk et al, 9 R$ 131,000 in the analysis by Ferreira et et al, 10 and the incredible value of R$ 190,000 was obtained in the study by Quadros et al 11 Two variables influence these large figures, which are substantially higher than the US $1,650 was found in the North-American study by Cohen et al 12 These variables are the following: the low incidence of clinical restenosis with BMS, which is exactly what we have seen in a study published in this issue (consequently, a higher number of patients need to be treated with DES to avoid restenosis); and the high prices of both stents in addition to the high DES/BMS cost ratio, which is always greater than 3, or in absolute terms, with a price difference between the two of greater than R$ 8,000.…”

Section: See Page 21mentioning

confidence: 99%

Questão simples, resposta multivariada

Feres¹,

Feres²,

Botelho³

2012

Rev. Bras. Cardiol. Invasiva

View full text Add to dashboard Cite

Discussion of the cost-effectiveness analysis of drugeluting stents (DES) is both extremely important and necessary, although challenging. Perhaps this urgency contradicts what research has recently demonstrated regarding such devices: the obvious clinical bene fit of DES in all analysed subgroups in randomised experimental scenarios and in real patients.1,2 This year marked the tenth anniversary of the use of this groundbreaking technology in our field. Several studies have shown both the efficacy and safety of these devices for coronary restenosis reduction compared with bare-metal stents (BMS).3-5 Data favouring their use have led to increased deployment. Cardiologists must consider the novelty and high cost of this technology; conversely, they must consider the undeniable benefits it provides. The question must be asked: is this treatment cost-effective? See page 21In the study published in this issue of the Revista Brasileira de Cardiologia Invasiva, Ferreira et al. 6 compared the performance of the Taxus ® DES and the Liberté ® BMS in consecutive, non-randomised patients. Even in countries where the DES/BMS relationship is not as heavily promoted as in this sample, and despite the reduction of restenosis with DES in all subgroups analysed, the development of a model of maximal benefits is necessary. In one of these recently published models, 7 the number needed to treat (NNT) with DES to avoid new revascularisation of the target vessel ranged from 6 to 80. This finding means that in certain subgroups, restenosis with BMS was so low that it would be necessary to treat 80 patients with DES in order to avoid a new procedure. Conversely, in other subgroups, restenosis with BMS was high, and the NNT with DES to avoid a new procedure was only 6. These concepts generate a proper discussion regarding the moment at which a decision must be made, and the clinician must compare the clinical benefit of using a device versus public health policies in order to optimize the incorporation of new technologies.The cost-effectiveness concept can be defined as the difference between the cost of the two interventions, expressed in monetary value, divided by the diffe rence between their effectiveness, expressed in years of life gained (life expectancy) or in order less important outcomes, such as the number of prevented complications and the number of averted non-fatal events.8 Regarding BMS, the following question must be asked: what is the additional cost for each new averted revascularisation? In Brazil, the values obtained in order to avoid either a new revascularisation or an event in the target vessel were R$ 47,000 in the analysis by Polanczyk et al.,

show abstract

“…O conceito de custo-efetividade pode ser traduzido como a diferença entre o custo de duas intervenções, expresso em valor monetário, dividido pela diferença entre suas efetividades, expressas em anos de vida ganhos (expectativa de vida) ou outros desfechos menos importantes, como complicações prevenidas e eventos não-fatais evitados. 12 Em relação aos SFs, a questão é a seguinte: qual o custo adicional para cada nova revascularização evitada? Em nosso meio, três estudos abordaram o tema.…”

Section: -Quais As Condições Para Uma Real Análise De Custo-efetividade?unclassified

Stents farmacológicos para todos!: como?

Feres¹,

Costa²,

Costa³

2011

Rev. Bras. Cardiol. Invasiva

View full text Add to dashboard Cite

Economic analysis of drug-eluting coronary stents in Brazil: a choice for all or just for a few patients?

Cited by 7 publications

References 8 publications

Methodological adequacy of articles published in two open-access Brazilian cardiology periodicals

Methodological adequacy of articles published in two open-access Brazilian cardiology periodicals

Questão simples, resposta multivariada

Stents farmacológicos para todos!: como?

Contact Info

Product

Resources

About