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. 2014 Nov;55(6):1533-41.
doi: 10.3349/ymj.2014.55.6.1533.

Cost-effectiveness of drug-eluting vs. bare-metal stents in patients with coronary artery disease from the Korean National Health Insurance Database

SooJin Lee  1 , KyungWon Baek  2 , Kihong Chun  3
Affiliations

Cost-effectiveness of drug-eluting vs. bare-metal stents in patients with coronary artery disease from the Korean National Health Insurance Database

SooJin Lee et al. Yonsei Med J. 2014 Nov.

Abstract

Purpose: The aim of this study was to evaluate the cost-effectiveness of the use of drug-eluting stents (DESs), as compared with bare-metal stents (BMSs) in Korea.

Materials and methods: A retrospective cohort study was conducted between January 2000 and December 2007. Subjects were stent-treated for the first time between 2004 and 2005, with four years of follow-up (2004-2007) (n=43674). The incremental cost-effectiveness ratio (ICER) was used to calculate the costs of DESs compared with BMSs among patients with coronary artery disease (CAD). Cost-effectiveness was assessed with effectiveness defined as a reduction in major adverse cardiac events after six months and after one, two, three, and four years.

Results: The total costs of a DESs were 674108 Korean won (KRW) higher than that of a BMSs at the end of the follow-up; 13635 thousand KRW per patient treated with DESs and 12960 thousand KRW per patient treated with BMSs. The ICER was 256315 per KRW/death avoided and 293090 per KRW/re-stenting avoided among the CAD patients at the end of the follow-up.

Conclusion: The ICER for the high-risk patients was lower than that for the low-risk patients. The use of DESs is clinically more useful than the use of BMSs for CAD and myocardial infarction patients, especially for those considered to be high-risk patients in Korea.

Keywords: Incremental cost effectiveness ratio; bare-metal stents; drug-eluting stents; stent implantation.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1
Cumulative survival rate in patients with drug-eluting stents and bare-metal stents. (A) Coronary artery disease patients. (B) Myocardial infarction patients. (C) Low-risk and high-risk coronary artery disease patients. (D) Low-risk and high-risk myocardial infarction patients. DES, drug-eluting stent; BMS, bare-metal stent; CAD, coronary artery disease; MI, myocardial infarction.
Fig. 2
Fig. 2
Cumulative re-stenting rate in patients with drug-eluting stents and bare-metal stents. (A) Coronary artery disease patients. (B) Myocardial infarction patients. (C) Low-risk and high-risk coronary artery disease patients. (D) Low-risk and high-risk myocardial infarction patients (***p<0.001). DES, drug-eluting stent; BMS, bare-metal stent; CAD, coronary artery disease; MI, myocardial infarction.
See this image and copyright information in PMC

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