Cost comparison of four revascularisation procedures for the treatment of multivessel coronary artery disease.
OBJECTIVE
An economic evaluation was performed, using modelling techniques, to compare 1-year total costs of four revascularisation procedures in patients with multivessel disease: on-pump coronary artery bypass grafting (CABG); off-pump CABG; percutaneous coronary intervention (PCI) with bare-metal stents (BMS); and PCI with drug-eluting stents (DES).


METHODS
Clinical data were derived from four randomised clinical trials comparing CABG versus PCI, as well as from literature reviews. Resource use and unit cost estimates were modelled to reflect current Canadian practice.


RESULTS
This study demonstrated that 1 year after the initial revascularisation, PCI with BMS is the least costly procedure, followed by off-pump CABG, PCI with DES and on-pump CABG. DES became the most costly procedure if 3.5 or more DES were used or if staged PCI was performed.
Wang
Xiaoyin
X
McMaster University, Department of Surgery, Division of Cardiac Surgery, Hamilton, Ontario, Canada.
Rokoss
Michael
M
Dyub
Adel
A
Gafni
Amiram
A
Lamy
Andre
A
D003324:Coronary Artery Disease / Q000150:complications / Q000191:economics* / Q000601:surgery*; D003365:Costs and Cost Analysis; D006801:Humans; D017059:Models, Econometric; D009204:Myocardial Revascularization / Q000191:economics* / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D015607:Stents / Q000191:economics