Cost-effectiveness of the Taxus paclitaxel-eluting stent in the Swedish healthcare system.
OBJECTIVE
To analyse the cost-effectiveness of Taxus compared to a bare-metal stent in patients with coronary artery disease in the Swedish healthcare setting.


METHODS
A decision-analytic model combining clinical data on revascularization rates with Swedish unit costs for medical resources and utility data from the literature.


RESULTS
For patients of moderate risk, the average cost per patient at 12 months is 72,200 SEK for Taxus and 66,900 SEK for a bare-metal stent, while the average cost for high risk patients is nearly equivalent (73,000 vs. 71,700 SEK). The cost per revascularization avoided is generally favourable, while the incremental cost per QALY gained varies depending on the assumptions made; from 2,351,000 SEK for patients of moderate risk at 12-months to cost saving at 24 months for high risk patients. Budget impact scenarios at 12 months are cost-neutral.


CONCLUSIONS
The Taxus stent is cost-effective in high risk patients, particularly at 24 months. Although it may be less cost-effective for the general population, there is still a substantial offset of initial procedure costs through lower rate of repeat revascularizations.
Ekman
Mattias
M
Stockholm Health Economics, Stockholm, Sweden. mattias.e@healtheconomics.se
Sjögren
Iwar
I
James
Stefan
S
D002986:Clinical Trials as Topic; D000077144:Clopidogrel; D001026:Coronary Artery Bypass / Q000191:economics*; D003324:Coronary Artery Disease / Q000188:drug therapy / Q000191:economics* / Q000601:surgery; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics*; D016503:Drug Delivery Systems / Q000191:economics*; D017048:Health Care Costs; D006801:Humans; D018803:Models, Economic; D009204:Myocardial Revascularization / Q000191:economics; D017239:Paclitaxel / Q000008:administration & dosage / Q000191:economics; D012086:Reoperation / Q000191:economics; D015607:Stents / Q000145:classification* / Q000191:economics* / Q000706:statistics & numerical data; D013548:Sweden; D020946:Taxus; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000191:economics
D000077144:Clopidogrel; D013988:Ticlopidine; D017239:Paclitaxel