Cost Effectiveness of Drug-Eluting Stents in Acute Myocardial Infarction Patients in Germany

Bäumler, Michael; Stargardt, Tom; Schreyögg, Jonas; Busse, Reinhard

doi:10.2165/11597340-000000000-00000

Cited by 11 publications

(18 citation statements)

References 29 publications

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“…Seven papers and one abstract reported direct medical cost of individual MI patients in Germany [ 10 – 17 ].…”

Section: Resultsmentioning

confidence: 99%

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Costs of treating cardiovascular events in Germany: a systematic literature review

Schmid

2015

Health Econ Rev

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ObjectiveThis study aims to systematically evaluate available evidence regarding direct medical costs of treating cardiovascular (CV) events in Germany after 2003 on an individual patient basis and from a payer perspective. The CV events of interest were myocardial infarction (MI), unstable angina, heart failure (HF), stroke, and peripheral artery disease (PAD).MethodA systematic literature search was performed in the following databases according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines - Medline, Embase, Centre for Reviews and Dissemination, TIBORDER, and German dissertation database from January 2003 to October 2013. Both observational studies and randomized clinical trials were considered for the review. All values stated in € are inflation adjusted to 2014 € unless stated otherwise.ResultThis review included 13 articles. For newly occurred MI patients, the average hospitalization costs during the acute phase were reported to be between € 6790 and € 8918 per admission. In the first year after a MI event, direct medical costs were € 13,838–14,792 per patient. Direct medical costs of chronic HF patients were found to be between € 3417 and 5576 per patient per year. Treatment costs increase with disease progression. The average treatment costs for hospitalized PAD in the acute phase were reported to be € 4963 per admission, € 2535 per patient during month 1–6 after the initial hospitalization, € 1601 in month 7–12, and € 1390 in month 13–18. For stroke of all types, total direct medical costs in the 1st year after an event were reported to be € 13,273 per patient. Total direct medical costs during the 1st year after an ischemic stroke event were € 17,399–21,954 per patient, € 6260 in month 13–18, and € 6496 per year in the subsequent 4 years.ConclusionMI, unstable angina, HF, stroke and PAD have a high financial impact on the German health care system. Treatment costs of these diseases are mostly incurred during the acute phase of events and tend to decrease over time. Hospitalization and rehabilitation costs were two major cost drivers. Medication costs was one of the smallest cost component reported.

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“…Seven papers and one abstract reported direct medical cost of individual MI patients in Germany [ 10 – 17 ].…”

Section: Resultsmentioning

confidence: 99%

“…During the first year after an AMI event, direct medical costs of treating AMI patients were reported to be from € 13,838 to 14,792/patient [ 10 , 17 ]. Total costs spent on male patients were about 21 % higher than those for females ( p ≤0.0001) [ 13 ].…”

Section: Resultsmentioning

confidence: 99%

Costs of treating cardiovascular events in Germany: a systematic literature review

Schmid

2015

Health Econ Rev

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“…Los hallazgos de esta investigación van en la misma línea que lo hallado en otras evaluaciones económicas para pacientes con IAMST, las cuales han encontrado resultados poco favorables para el stent medicado, y mucha incertidumbre alrededor de la estimación y la decisión, recomendando, por tanto, mayor investigación respecto al tema 24,25 . No obstante, es importante notar que hacer una comparación directa entre los resultados de la literatura internacional puede no ser adecuado debido a que las diferencias en aspectos metodológicos y en los modelos tarifarios y de contratación pueden ser muy variables, e impactar de manera significativa los resultados encontrados según el contexto de salud 26 .…”

Section: Resultsunclassified

Evaluación económica del stent medicado vs. convencional para pacientes con infarto agudo de miocardio con elevación del ST en Colombia

Ceballos¹

2014

Revista Colombiana de Cardiología

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Recibido el 1 de noviembre de 2013; aceptado el 16 de junio de 2014 Disponible en Internet el 22 de enero de 2015 PALABRAS CLAVEAnálisis de costo-efectividad; Evaluación económica; Stent; Stents liberadores de fármacos; Infarto agudo de miocardio con elevación del ST ResumenObjetivo: Analizar la costo-efectividad y el valor esperado de la información perfecta del stent medicado con sirolimus comparado con el convencional para pacientes con infarto agudo de miocardio con elevación del ST en Colombia. Métodos: Se construyó un modelo de Markov bajo la perspectiva del pagador y un horizonte temporal de diez años. Las probabilidades de transición se extrajeron de estudios clínicos identificados a partir de revisiones de la literatura. Los costos se estimaron mediante el uso de consenso de expertos y manuales tarifarios colombianos. Se realizó un análisis de sensibilidad determinístico alrededor del horizonte temporal, precio del stent medicado y tasa de descuento. Se construyó un análisis de sensibilidad probabilístico (10.000 simulaciones de Monte Carlo) y el valor esperado de la información perfecta para la decisión global y grupos de parámetros. Resultados: En el caso base, el costo por año de vida ajustado por calidad se ubicó en 53.749.654 $. Los resultados no son sensibles al horizonte temporal ni a la tasa de descuento, pero sí al precio del stent medicado. El valor esperado de la información perfecta fue significativamente mayor para la probabilidad de muerte y de sufrir una trombosis muy tardía del stent. Conclusiones: El stent medicado con sirolimus no es costo-efectivo para pacientes con infarto agudo de miocardio con elevación del ST en Colombia. Se recomienda mayor investigación futura sobre la probabilidad de muerte y trombosis muy tardía del stent, así como en subgrupos específicos de pacientes y stents medicados de segunda generación.

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“…For example, propensity score analysis has been used to assess the quality of diabetes care, 13 COPD maintenance therapies, 27 the costs and lengths of stay of total hip replacement, 28 the cost-effectiveness of open laparoscopic appendectomies, 29 and the cost-effectiveness of drug-eluting stents in patients with acute myocardial infarction. 30 In summary, we were interested in exploring the impact of the Incentive Program on health care costs while controlling for several key cost-related variables. Having access to the BC Ministry of Health administrative databases, which consist of a series of registries that contain the records of people with chronic conditions, we were able to examine and compare costs and hospital utilization patterns for patients on the registries for diabetes, CHF, COPD, and hypertension.…”

Section: Original Research and Contributionsmentioning

confidence: 99%

Incentive-Based Primary Care: Cost and Utilization Analysis

Hollander¹,

Kadlec²

2015

TPJ

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Cost Effectiveness of Drug-Eluting Stents in Acute Myocardial Infarction Patients in Germany

Cited by 11 publications

References 29 publications

Costs of treating cardiovascular events in Germany: a systematic literature review

Costs of treating cardiovascular events in Germany: a systematic literature review

Evaluación económica del stent medicado vs. convencional para pacientes con infarto agudo de miocardio con elevación del ST en Colombia

Incentive-Based Primary Care: Cost and Utilization Analysis

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