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. 2023 Feb 15;21(1):16.
doi: 10.1186/s12962-023-00426-y.

Cost-effectiveness analysis of coronary arteries bypass grafting (CABG) and percutaneous coronary intervention (PCI) through drug stent in iran: a comparative study

NourolHoda Fakhrzad  1 , Mohsen Barouni  2 , Reza Goudarzi  1 , Javad Kojuri  3 , Yunes Jahani  4 , Mohammad Tasavon Gholamhoseini  1
Affiliations

Cost-effectiveness analysis of coronary arteries bypass grafting (CABG) and percutaneous coronary intervention (PCI) through drug stent in iran: a comparative study

NourolHoda Fakhrzad et al. Cost Eff Resour Alloc. .

Abstract

Background: Cost-effectiveness analysis plays a key role in evaluating health systems and services. Coronary artery disease is one of the primary health concerns worldwide. This study sought to compare the cost-effectiveness of Coronary Arteries Bypass Grafting (CABG) and Percutaneous Coronary Intervention (PCI) through drug stent using Quality-Adjusted Life Years (QALY) index.

Methods: This is a cohort study involving all patients undergoing CABG and PCI through drug stent in south of Iran. A total of 410 patients were randomly selected to be included in the study. Data were gathered using SF-36, SAQ and a form for cost data from the patients' perspective. The data were analyzed descriptively and inferentially. Considering the analysis of cost-effectiveness, Markov Model was initially developed using TreeAge Pro 2020. Both deterministic and probabilistic sensitivity analyses were performed.

Results: Compared with the group treated with PCI, the total cost of interventions was higher in the CABG group ($102,103.8 vs $71,401.22) and the cost of lost productivity ($20,228.68 vs $7632.11), while the cost of hospitalization was lower in CABG ($67,567.1 vs $49,660.97). The cost of hotel stay and travel ($6967.82 vs $2520.12) and the cost of medication ($7340.18 vs $11,588.01) was lower in CABG. From the patients' perspective and SAQ instrument, CABG was cost-saving, with a reduction of $16,581 for every increase in effectiveness. Based on patients' perspective and SF-36 instrument, CABG was cost-saving, with a reduction of $34,543 for every increase in effectiveness.

Conclusion: In the same indications, CABG intervention leads to more resource savings.

Keywords: Costs-effectiveness; Markov model; Quality-Adjusted Life Years; Seattle angina questionnaire; Short form-36 questionnaire.

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Conflict of interest statement

There is no competing interest related to this study.

Figures

Fig. 1
Fig. 1
Markov model used for coronary diseases
Fig. 2
Fig. 2
Tornado plot for sensitivity analysis
Fig. 3
Fig. 3
Cost-effectiveness acceptability curve (QALY)
Fig. 4
Fig. 4
Probabilistic sensitivity analysis, average annual cost, and quality-adjusted life year (QALY)
See this image and copyright information in PMC

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