{"title":"Cost-Effectiveness of a Novel Self-Apposing Stent in ST-Segment Elevation Myocardial Infarction (STEMI) in France","authors":"L. Annemans, J. Silvain, G. Montalescot","doi":"10.33590/emjcardiol/10311664","DOIUrl":null,"url":null,"abstract":"The objective was to calculate the cost-effectiveness profile of STENTYS compared to conventional bare and drug-eluting stents (DES). Stents are widely used in the treatment of patients with ST-segment elevation myocardial infarction (STEMI). However, several reports point to the prevailing risk of coronary events such as recurrent myocardial infarction, some of which are related to in-stent thrombosis, possibly explained by poorly apposed stents. 1-year results of the self-apposing stent, STENTYS, are promising regarding the incidence of fatal and non-fatal cardiovascular (CV) events. A model was developed to simulate costs and quality-adjusted life years (QALYs) over 1-5 years. In the first 12 months, a decision tree framework was used to define different CV outcomes for STEMI patients receiving a stent. After 12 months, outcomes were categorised in a Markov stage of the model as myocardial infarction (MI), other CV events, revascularisation, and death. Cost of comparative treatments and follow-up in relation to CV events were calculated from the French health insurance perspective. The results indicated, in the base case, over a time horizon of 5 years, that STENTYS bare metal stent (BMS) is dominant (less costly and more QALYs) against conventional DES. The STENTYS DES is dominant compared with conventional DES and very cost-effective versus BMS. The results were robust for different variations in the input variables. This first analysis of the cost-effectiveness of STENTYS showed that it is dominant or very costeffective as compared to conventional stents. Further comparative research and longer follow-up data are needed to expand on these results.","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"33 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2015-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"EMJ Cardiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.33590/emjcardiol/10311664","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
The objective was to calculate the cost-effectiveness profile of STENTYS compared to conventional bare and drug-eluting stents (DES). Stents are widely used in the treatment of patients with ST-segment elevation myocardial infarction (STEMI). However, several reports point to the prevailing risk of coronary events such as recurrent myocardial infarction, some of which are related to in-stent thrombosis, possibly explained by poorly apposed stents. 1-year results of the self-apposing stent, STENTYS, are promising regarding the incidence of fatal and non-fatal cardiovascular (CV) events. A model was developed to simulate costs and quality-adjusted life years (QALYs) over 1-5 years. In the first 12 months, a decision tree framework was used to define different CV outcomes for STEMI patients receiving a stent. After 12 months, outcomes were categorised in a Markov stage of the model as myocardial infarction (MI), other CV events, revascularisation, and death. Cost of comparative treatments and follow-up in relation to CV events were calculated from the French health insurance perspective. The results indicated, in the base case, over a time horizon of 5 years, that STENTYS bare metal stent (BMS) is dominant (less costly and more QALYs) against conventional DES. The STENTYS DES is dominant compared with conventional DES and very cost-effective versus BMS. The results were robust for different variations in the input variables. This first analysis of the cost-effectiveness of STENTYS showed that it is dominant or very costeffective as compared to conventional stents. Further comparative research and longer follow-up data are needed to expand on these results.