The cost-effectiveness of beta-radiation therapy for treatment of in-stent restenosis: an analysis at 290-day follow-up.
OBJECTIVE
We studied the cost-effectiveness of percutaneous coronary intervention (PCI) plus beta-radiation (Radiotherapy) vs. PCI alone for treating in-stent restenosis.


METHODS
We analyzed medical resource data collected at US sites during the Intimal Hyperplasia Inhibition with beta In-stent Trial (INHIBIT) to compare the incremental costs between Radiotherapy and PCI alone for each repeat target lesion revascularization (TLR) avoided. Costs were assigned for cardiac-related medical services using the Medicare payer perspective.


RESULTS
Radiotherapy increased initial inpatient costs by US$3360 (P<.001). In the Radiotherapy and PCI alone groups, the mean per-patient rates for TLR were 0.13 vs. 0.30 (P=.001), and mean per-patient total costs were US$19,286 vs. US$18,349 (P<.001), respectively. The incremental cost of Radiotherapy relative to PCI alone was US$5512 per TLR avoided, which compares favorably to the observed mean per-patient cost of treating restenosis (US$16,852).


CONCLUSIONS
beta-radiation is a cost-effective adjunct to PCI in treating patients with in-stent restenosis.
Beusterien
Kathleen M
KM
Covance Health Economics and Outcomes Services, 9801 Washingtonian Boulevard, Ninth Floor, Gaithersburg, MD 20878, USA.
Plante
Kathryn M
KM
Waksman
Ron
R
Raizner
Albert E
AE
Annis
Marijke
M
Goss
Thomas F
TF
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000191:economics*; D001610:Beta Particles / Q000627:therapeutic use*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000191:economics*; D003324:Coronary Artery Disease / Q000191:economics* / Q000601:surgery*; D003362:Cost-Benefit Analysis; D005260:Female; D006083:Graft Occlusion, Vascular / Q000191:economics* / Q000209:etiology / Q000628:therapy*; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D011878:Radiotherapy / Q000191:economics*; D018714:Radiotherapy, Adjuvant / Q000191:economics; D016032:Randomized Controlled Trials as Topic / Q000191:economics; D012189:Retrospective Studies