Department of Health Management, Ankara University School of Health Science, Ankara, Turkey
Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey
Balkan Med J. 2019 Aug 22;36(5):276-282. doi: 10.4274/balkanmedj.galenos.2019.2018.12.28. Epub 2019 Jul 10.
There is only limited information about the cost-effectiveness of drug-eluting stents compared with bare-metal stents in Turkey.
To evaluate bare-metal and drug-eluting stents used in the treatment of coronary artery disease from the perspective of the reimbursement institution with cost-effectiveness analysis.
Retrospective cost-effectiveness analysis.
In our study, 329 patients diagnosed with coronary artery disease and treated with bare-metal or drug-eluting stents in the cardiology clinics of a public university hospital between January 1 and December 31, 2016 were investigated. Bare-metal and drug-eluting stents used in the treatment of coronary artery disease were evaluated retrospectively with cost-effectiveness analysis from the perspective of the reimbursement institution.
The cost of treatment with a bare-metal stent was 2,131.41 Turkish Liras, and the cost of treatment with a drug-eluting stent was 3,546.14 Turkish Liras; the Quality Adjusted Life Years value of treatment with a bare-metal stent was 0.8371, and the Quality Adjusted Life Years value of treatment with a drug-eluting stent was 0.8924. All these data were analyzed by decision tree. As a result of decision tree analysis, the weighted cost of treatment with a bare-metal stent was 2,340.71 Turkish Liras and weighted Quality Adjusted Life Years value was 0.8332; and the weighted cost of treatment with drug-eluting stent was 3,970.90 Turkish Liras and the weighted Quality Adjusted Life Years value of the treatment with drug-eluting stent was 0.8911. With these values, the additional cost-effectiveness ratio was calculated as 28,179.12 Turkish Liras per acquired Quality Adjusted Life Years. The additional cost-effectiveness ratio is in the first zone in the cost-effectiveness plane and below the very threshold of cost-effectiveness.
In our study, it was concluded that drug-eluting stents are cost effective compared with bare-metal stents in the treatment of coronary artery disease. Considering the cost and effectiveness of the drug-eluting stent, it is thought that increasing reimbursement for this technology by the reimbursement agency would be beneficial for the service provider.
土耳其仅有少量关于药物洗脱支架与裸金属支架相比的成本效益信息。
从报销机构的角度，通过成本效益分析评估在治疗冠状动脉疾病中使用裸金属支架和药物洗脱支架的情况。
回顾性成本效益分析。
本研究调查了 2016 年 1 月 1 日至 12 月 31 日期间在一所公立大学医院心内科诊所因冠状动脉疾病接受裸金属或药物洗脱支架治疗的 329 例患者。从报销机构的角度，回顾性评估治疗冠状动脉疾病时使用裸金属支架和药物洗脱支架的成本效益。
裸金属支架治疗的费用为 2131.41 土耳其里拉，药物洗脱支架治疗的费用为 3546.14 土耳其里拉；裸金属支架治疗的质量调整生命年值为 0.8371，药物洗脱支架治疗的质量调整生命年值为 0.8924。所有这些数据均通过决策树进行分析。决策树分析结果显示，裸金属支架治疗的加权费用为 2340.71 土耳其里拉，加权质量调整生命年值为 0.8332；药物洗脱支架治疗的加权费用为 3970.90 土耳其里拉，加权药物洗脱支架治疗的质量调整生命年值为 0.8911。根据这些数值，每获得一个质量调整生命年的附加成本效益比为 28179.12 土耳其里拉。附加成本效益比位于成本效益平面的第一区且低于成本效益的非常阈值。
本研究认为，在治疗冠状动脉疾病中，与裸金属支架相比，药物洗脱支架具有成本效益。考虑到药物洗脱支架的成本和效果，报销机构增加对该技术的报销可能对服务提供者有利。
