Cost Effectiveness of Paclitaxel-Eluting Stents for Patients Undergoing Percutaneous Coronary Revascularization. Results From the TAXUS-IV Trial

64Citations
Citations of this article
24Readers
Mendeley users who have this article in their library.

Abstract

Objectives: This study sought to compare aggregate medical care costs for patients undergoing percutaneous coronary intervention with paclitaxel-eluting stents (PES) and bare-metal stents (BMS) and to formally evaluate the incremental cost effectiveness of PES for patients undergoing single-vessel percutaneous coronary intervention. Background: Although the cost effectiveness of SES has been studied in both clinical trials and decision-analytic models, few data exist on the cost effectiveness of alternative drug-eluting stent (DES) designs. In addition, no clinical trials have specifically examined the cost effectiveness of DES among patients managed without mandatory angiographic follow-up. Methods: We performed a prospective economic evaluation among 1,314 patients undergoing percutaneous coronary revascularization randomized to either PES (N = 662) or BMS (N = 652) in the TAXUS-IV trial. Clinical outcomes, resource use, and costs (from a societal perspective) were assessed prospectively for all patients over a 1-year follow-up period. Cost effectiveness was defined as the incremental cost per target vessel revascularization (TVR) event avoided and was analyzed separately among cohorts assigned to mandatory angiographic follow-up (n = 732) or clinical follow-up alone (n = 582). Results: The PES reduced TVR by 12.2 events per 100 patients treated, resulting in a 1-year cost difference of $572 per patient with incremental cost-effectiveness ratios of $4,678 per TVR avoided and $47,798/quality-adjusted life year (QALY) gained. Among patients assigned to clinical follow-up alone, the net 1-year cost difference was $97 per patient with cost-effectiveness ratios of $760 per TVR event avoided and $5,105/QALY gained. Conclusions: In the TAXUS-IV trial, treatment with PES led to substantial reductions in the need for repeat revascularization while increasing 1-year costs only modestly. The cost-effectiveness ratio for PES in the study population compares reasonably with that for other treatments that reduce coronary restenosis, including alternative drug-eluting stent platforms. © 2006 American College of Cardiology Foundation.

Cite

CITATION STYLE

APA

Bakhai, A., Stone, G. W., Mahoney, E., Lavelle, T. A., Shi, C., Berezin, R. H., … Cohen, D. J. (2006). Cost Effectiveness of Paclitaxel-Eluting Stents for Patients Undergoing Percutaneous Coronary Revascularization. Results From the TAXUS-IV Trial. Journal of the American College of Cardiology, 48(2), 253–261. https://doi.org/10.1016/j.jacc.2006.02.063

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free