Use of Drug-eluting Stents Versus Bare-metal Stents in  Korea: A Cost-minimization Analysis Using Population  Data

서혜선; 송현진; 장은진; 김정선; 최동훈; 이상무

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자료유형: 학술저널

저자정보: 서혜선 송현진 장은진 김정선 최동훈 이상무

저널정보: 대한예방의학회 예방의학회지 예방의학회지 제46권 제4호

발행연도: 2013.1

수록면: 201 - 209 (9page)

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연구배경

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연구방법

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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.

#Myocardial infarction #Drug-eluting stents #Costs and cost analysis #Pharmaceutical economics

참고문헌 (19)

참고문헌 신청

Brar SS / 2009 / Use of drug-eluting stents in acute myocardial infarction: a systematic r

Cho Y / 2010 / Paclitaxel- versus sirolimus-eluting stents for treatment of STsegment elevation myocardial infarction: with analyses for diabetic and nondiabetic subpopulati

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Kim KH / 2012 / Comparison of drug-eluting versus bare-metal stent implantation in ST-elevation myocardial infarction patients with renal insufficiency: results from the nat

Korea Centers for Disease Control and Prevention / 2005 / The Korea National Health and Nutrition Examination Survey (KNHANES III) : 174 ~ 177