title: A break-even price calculation for the use of sirolimus-eluting stents in angioplasty.
abstract: BACKGROUND
  One of the major complications of angioplasty is the early occurrence of restenosis requiring a repeat procedure. When bare-metal stents are used, clinical restenosis results in a repeat procedure in 10% to 15% of cases. Based on the results of an international, randomized clinical trial, the use of sirolimus-eluting stents reduces this risk.
  
  
  OBJECTIVE
  The aims of this study were to calculate the theoretical break-even price for sirolimus-eluting stents in France, the Netherlands, and the United States, and to determine the additional health care cost per patient.
  
  
  METHODS
  The break-even price was calculated by adding the savings resulting from a 15% decrease in the rate of clinical restenosis to the price of bare-metal stents. Costs were computed from the viewpoint of the health care system, exclusive of other societal costs.
  
  
  RESULTS
  The break-even prices were 1291 Euro to 1489 Euro in France, 2028 Euro in the Netherlands, and 2708 Euroin the United States (1.00 Euro = 1.00 US dollar in purchasing power parity). These results indicate that the commercial price of sirolimuseluting stents will increase hospital spending for patients undergoing angioplasty by 17% to 55% per patient.
  
  
  CONCLUSIONS
  This additional cost to the health care system should be discussed in view of possible productivity savings and improved quality of life for patients.
authors.affiliation: Public Health Service, Henri Mondor Hospital, Public Assistance Hospitals of Paris, Paris, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Galanaud
authors.forename: Juliette
authors.initials: J
authors.lastname: Delavennat
authors.forename: Isabelle
authors.initials: I
authors.lastname: Durand-Zaleski
mesh_terms: D017130:Angioplasty / Q000191:economics*; D015906:Angioplasty, Balloon, Coronary / Q000191:economics; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000628:therapy; D023903:Coronary Restenosis / Q000517:prevention & control*; D003331:Coronary Vessels; D003362:Cost-Benefit Analysis; D005602:France; D006801:Humans; D007166:Immunosuppressive Agents / Q000191:economics*; D009426:Netherlands; D020123:Sirolimus / Q000191:economics*; D015607:Stents / Q000191:economics*; D014481:United States
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus