Cost-Effectiveness of Three Different New-Generation Drug-Eluting Stents in the Randomised BIO-RESORT Trial at 3 Years.

IF 2 Q2 ECONOMICS

PharmacoEconomics Open Pub Date : 2024-10-29 DOI:10.1007/s41669-024-00539-x

Eline H Ploumen, Martijn J Oude Wolcherink, Rosaly A Buiten, Tineke H Pinxterhuis, Carine J M Doggen, Carl E Schotborgh, Peter W Danse, Martijn Scholte, K Gert van Houwelingen, Paolo Zocca, Xavier G L V Pouwels, Clemens von Birgelen

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Abstract

Background and objective: Evidence on health economic outcomes for percutaneous coronary intervention (PCI) comparing different contemporary drug-eluting stents (DES) with each other is scarce, as most previous randomised DES trials did not assess such aspects. This prespecified health economic evaluation of the Comparison of Biodegradable Polymer and Durable Polymer Drug-Eluting Stents in an All Comers Population (BIO-RESORT) trial aimed to compare at 3-year follow-up both health effects and costs of PCI with one of three new-generation drug-eluting stents (DES) in patients with obstructive coronary artery disease.

Methods: The randomised BIO-RESORT trial assessed in 3514 patients the ultrathin-strut biodegradable polymer Orsiro sirolimus-eluting stent (SES) and very-thin-strut Synergy everolimus-eluting (EES) stent versus the thin-strut durable polymer Resolute Integrity zotarolimus-eluting stent (ZES). In the current analysis, we used the perspective of a health insurer in the Netherlands. The main endpoints were quality-adjusted life years (QALYs), and costs for each treatment strategy. Bootstrapping with 5000 resamples was performed to capture the uncertainty of results.

Results: Mean QALYs for each stent group were 2.566 for the SES, 2.551 for the EES, and 2.550 for the ZES. Mean costs per strategy were €14,670 for the SES, €14,946 for the EES, and €15,069 for the ZES. The SES had the highest probability of being cost-effective for every willingness-to-pay threshold up to €100,000 per QALY. Furthermore, in 79% of modelling scenarios, the SES was more effective and cheaper than ZES.

Conclusion: At 3-year follow-up, PCI with the SES had the highest probability of being cost-effective due to greater effectiveness and lower costs compared with the ZES and EES. These findings suggest that, due to the overall high volume of coronary stenting in clinical practice, use of this SES could result in substantial cost savings, complemented by slight additional health benefits.

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随机 BIO-RESORT 试验中三种不同新一代药物洗脱支架 3 年后的成本效益。

背景和目的：有关经皮冠状动脉介入治疗（PCI）的健康经济学结果的证据很少，无法对不同的当代药物洗脱支架（DES）进行比较，因为之前的大多数随机药物洗脱支架试验都没有对这些方面进行评估。生物降解聚合物药物洗脱支架与耐用聚合物药物洗脱支架在所有人群中的比较（BIO-RESORT）试验的预设健康经济评估旨在比较阻塞性冠状动脉疾病患者使用三种新一代药物洗脱支架（DES）中的一种进行PCI治疗的3年随访健康影响和成本：随机BIO-RESORT试验在3514名患者中评估了超薄支架生物可降解聚合物Orsiro西罗莫司洗脱支架（SES）和超薄支架Synergy依维莫司洗脱支架（EES）与薄支架耐用聚合物Resolute Integrity佐他莫司洗脱支架（ZES）。在本次分析中，我们从荷兰一家医疗保险公司的角度进行了分析。主要终点是每种治疗策略的质量调整生命年（QALYs）和成本。为了捕捉结果的不确定性，我们进行了 5000 次重新采样的 Bootstrapping 分析：各支架组的平均质量调整生命年分别为：SES 2.566，EES 2.551，ZES 2.550。每个策略的平均成本分别为：SES 14,670 欧元，EES 14,946 欧元，ZES 15,069 欧元。在每 QALY 100,000 欧元以下的每个支付意愿阈值中，SES 具有成本效益的概率最高。此外，在79%的建模方案中，SES比ZES更有效、更便宜：结论：在 3 年的随访中，与 ZES 和 EES 相比，使用 SES 进行 PCI 的有效性更高、成本更低，因此具有成本效益的可能性最大。这些研究结果表明，由于临床实践中冠状动脉支架植入术的总体数量较多，使用这种 SES 可以节省大量成本，同时还能带来轻微的额外健康益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

PharmacoEconomics Open Multiple-

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

8 weeks

期刊介绍： PharmacoEconomics - Open focuses on applied research on the economic implications and health outcomes associated with drugs, devices and other healthcare interventions. The journal includes, but is not limited to, the following research areas:Economic analysis of healthcare interventionsHealth outcomes researchCost-of-illness studiesQuality-of-life studiesAdditional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in PharmacoEconomics -Open may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.All manuscripts are subject to peer review by international experts. Letters to the Editor are welcomed and will be considered for publication.