Análise de custo-efetividade dos stents farmacológicos e não farmacológicos na doença coronariana

Ferreira, Eugénia; Araújo, Denizar Vianna; Azevedo, Vitor Manuel Pereira; Rodrigues, Cyro Vargues; Ferreira, A. C.; Junqueira, Camillo de Léllis Carneiro; Amino, José Geraldo de Castro; Farias, Mara Lucia; Neto, Antonio Farias; Albuquerque, Denílson Campos de

doi:10.1590/s0066-782x2010000300005

Cited by 12 publications

(5 citation statements)

References 15 publications

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“…When the costs of these two health technologies are compared, it is concluded that DES is more costly than BMS. In a survey of the related literature, the cost of DES was found to be greater than that of BMS in studies with similar or different perspectives, as in our study (15,16,17,18,19,20,21,22,23,24,25,26,27,28).…”

Section: Discussionsupporting

confidence: 72%

“…The mean length of hospital stay (1.59 days) of patients treated with DES was shorter than that (1.93 days) of patients treated with BMS. In studies on this subject, effectiveness was compared with various parameters, and the effectiveness of DES was found to be higher than the effectiveness of BMS (19,23,24,26,27). Some studies in the literature also concluded that DES is more effective in high-risk patients (17,18,20,22).…”

Section: Discussionmentioning

confidence: 99%

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Cost Effectiveness Analysis of Stents Used in Treatment of Coronary Artery Disease

2019

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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.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Cost Effectiveness Analysis of Stents Used in Treatment of Coronary Artery Disease

2019

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“…The 16 eligible studies were divided into five groups based on the type of DES that was evaluated and accounted for 498 separate analyses (Table 1 ). Four studies calculated the incremental cost-effectiveness ratio (ICER) for both PES and SES [ 2 , 12 – 14 ], two studies [ 15 , 16 ] focused on PES, three studies focused only on SES [ 17 – 19 ], and one study used ZES as the intervention [ 20 ]. The remaining six publications [ 8 , 10 , 11 , 21 – 24 ] did not specifically identify the type of eluting drug under evaluation and calculated an ICER for a DES in general,…”

Section: Resultsmentioning

confidence: 99%

“…In most analyses, DES was more expensive (88 % of analyses) and more effective in both QALYs and repeat revascularizations avoided (99 % of analyses) than BMS. Most of the 16 studies [ 2 , 8 , 10 , 11 , 14 , 16 , 21 , 23 ] concluded that DES is not cost-effective for all subgroups since the incremental QALYs did not offset the incremental costs. However, many concluded that DES was more cost-effective in high-risk patients.…”

Section: Resultsmentioning

confidence: 99%

Using meta-regression analyses in addition to conventional systematic review methods to examine the variation in cost-effectiveness results – a case study

Burgers

Wetering

Severens

et al. 2015

BMC Health Serv Res

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BackgroundSystematic reviews of cost-effectiveness analyses summarize results and describe study characteristics. Variability in the study results is often explained qualitatively or based on sensitivity analyses of individual studies. However, variability due to input parameters and study characteristics (e.g., funding or study quality) is often not statistically explained. As a case study, a systematic review on the cost-effectiveness of drug-eluting stents (DES) versus bare-metal stents (BMS) using meta-regression analyses is performed to explore the usefulness of such methods compared with conventional review methods.MethodsWe attempted to identify and review all modelling studies published until January 2012 that compared costs and consequences of DES versus BMS. We extracted general study information (e.g., funding), modelling methods, values of input parameters, and quality of the model using the Philips et al. checklist. Associations between study characteristics and the incremental costs and effectiveness of individual analyses were explored using regression analyses corrected for study ID.ResultsSixteen eligible studies were identified, with a combined total of 508 analyses. The overall quality of the models was moderate (59 % ± 15 %). This study showed associations (e.g., type of lesion) that were expected (based on individual studies), however the meta-regression analyses revealed also unpredicted associations: e.g., model quality was negatively associated with repeat revascularizations avoided.ConclusionsMeta-regressions can be of added value, identifying significant associations that could not be identified using conventional review methods or by sensitivity analyses of individual studies. Furthermore, this study underlines the need to examine input parameters and perform a quality check of studies when interpreting the results.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-1230-4) contains supplementary material, which is available to authorized users.

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“…The values found in our analysis are well below these thresholds. However, our work did not evaluate quality-adjusted life years; therefore, we followed other studies that used the WTP threshold reference for other relevant outcomes [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

Assessing the cost-effectiveness of capnography for end-tidal CO2 monitoring during in-hospital cardiac arrest: A middle-income country perspective analysis

da Rosa Decker,

Marzzani,

de Ferreira

et al. 2024

American Heart Journal Plus: Cardiology Research and Practice

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Análise de custo-efetividade dos stents farmacológicos e não farmacológicos na doença coronariana

Abstract: Background: There is a scarcity of cost-effectiveness analyses in the national literature comparing drug-eluting stents (DES) with bare-metal stents (BMS), at late follow-up.

Cited by 12 publications

References 15 publications

Cost Effectiveness Analysis of Stents Used in Treatment of Coronary Artery Disease

Cost Effectiveness Analysis of Stents Used in Treatment of Coronary Artery Disease

Using meta-regression analyses in addition to conventional systematic review methods to examine the variation in cost-effectiveness results – a case study

Assessing the cost-effectiveness of capnography for end-tidal CO2 monitoring during in-hospital cardiac arrest: A middle-income country perspective analysis

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