Use of drug-eluting stents versus bare-metal stents in Korea

A cost-minimization analysis using population data

Hae Sun Suh, Hyun Jin Song, Eun Jin Jang, Jung Sun Kim, Donghoon Choi, Sang Moo Lee

Research output: Contribution to journalArticle

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Abstract

Objectives: The goal of this study was to perform an economic analysis of a primary stenting with drug-eluting stents (DES) compared with bare-metal stents (BMS) in patients with acute myocardial infarction (AMI) admitted through an emergency room (ER) visit in Korea using population-based data. Methods: We employed a cost-minimization method using a decision analytic model with a two-year time period. Model probabilities and costs were obtained from a published systematic review and population-based data from which a retrospective database analysis of the national reimbursement database of Health Insurance Review and Assessment covering 2006 through 2010 was performed. Uncertainty was evaluated using one-way sensitivity analyses and probabilistic sensitivity analyses. Results: Among 513 979 cases with AMI during 2007 and 2008, 24 742 cases underwent stenting procedures and 20 320 patients admitted through an ER visit with primary stenting were identified in the base model. The transition probabilities of DES-to-DES, DES-to- BMS, DES-to-coronary artery bypass graft, and DES-to-balloon were 59.7%, 0.6%, 4.3%, and 35.3%, respectively, among these patients. The average two-year costs of DES and BMS in 2011 Korean won were 11 065 528 won/person and 9 647 647 won/person, respectively. DES resulted in higher costs than BMS by 1 417 882 won/person. The model was highly sensitive to the probability and costs of having no revascularization. Conclusions: Primary stenting with BMS for AMI with an ER visit was shown to be a cost-saving procedure compared with DES in Korea. Caution is needed when applying this finding to patients with a higher level of severity in health status.

Original languageEnglish
Pages (from-to)201-209
Number of pages9
JournalJournal of Preventive Medicine and Public Health
Volume46
Issue number4
DOIs
Publication statusPublished - 2013 Jul 1

Fingerprint

Drug-Eluting Stents
Korea
Stents
Metals
Costs and Cost Analysis
Population
Hospital Emergency Service
Myocardial Infarction
Databases
Health Insurance Reimbursement
Coronary Artery Bypass
Health Status
Uncertainty
Economics
Transplants

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health

Cite this

Suh, Hae Sun ; Song, Hyun Jin ; Jang, Eun Jin ; Kim, Jung Sun ; Choi, Donghoon ; Lee, Sang Moo. / Use of drug-eluting stents versus bare-metal stents in Korea : A cost-minimization analysis using population data. In: Journal of Preventive Medicine and Public Health. 2013 ; Vol. 46, No. 4. pp. 201-209.
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abstract = "Objectives: The goal of this study was to perform an economic analysis of a primary stenting with drug-eluting stents (DES) compared with bare-metal stents (BMS) in patients with acute myocardial infarction (AMI) admitted through an emergency room (ER) visit in Korea using population-based data. Methods: We employed a cost-minimization method using a decision analytic model with a two-year time period. Model probabilities and costs were obtained from a published systematic review and population-based data from which a retrospective database analysis of the national reimbursement database of Health Insurance Review and Assessment covering 2006 through 2010 was performed. Uncertainty was evaluated using one-way sensitivity analyses and probabilistic sensitivity analyses. Results: Among 513 979 cases with AMI during 2007 and 2008, 24 742 cases underwent stenting procedures and 20 320 patients admitted through an ER visit with primary stenting were identified in the base model. The transition probabilities of DES-to-DES, DES-to- BMS, DES-to-coronary artery bypass graft, and DES-to-balloon were 59.7{\%}, 0.6{\%}, 4.3{\%}, and 35.3{\%}, respectively, among these patients. The average two-year costs of DES and BMS in 2011 Korean won were 11 065 528 won/person and 9 647 647 won/person, respectively. DES resulted in higher costs than BMS by 1 417 882 won/person. The model was highly sensitive to the probability and costs of having no revascularization. Conclusions: Primary stenting with BMS for AMI with an ER visit was shown to be a cost-saving procedure compared with DES in Korea. Caution is needed when applying this finding to patients with a higher level of severity in health status.",
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Use of drug-eluting stents versus bare-metal stents in Korea : A cost-minimization analysis using population data. / Suh, Hae Sun; Song, Hyun Jin; Jang, Eun Jin; Kim, Jung Sun; Choi, Donghoon; Lee, Sang Moo.

In: Journal of Preventive Medicine and Public Health, Vol. 46, No. 4, 01.07.2013, p. 201-209.

Research output: Contribution to journalArticle

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