Cost analysis of sirolimus-eluting stents in the Japanese health insurance system.
The cost-effectiveness of drug-eluting stents (DES) has been evaluated in the United States and Europe, however, there is little information from Japan. The present study evaluated the cost-effectiveness of sirolimus-eluting stents (SES) in Japan. In-hospital and follow-up costs of 25 consecutive patients undergoing SES implantation in a de novo lesion were evaluated. A control group for comparison was composed of 25 consecutive patients undergoing bare metal stent (BMS) implantation in a de novo lesion before the introduction of SES. There was no significant difference in resource use between the SES and BMS groups. Procedural cost (yen1,049,200 +/- 208,793 versus yen896,590 +/- 117,984, P = 0.01) was higher in the SES group than in the BMS group because of the higher reimbursement price of SES (yen378,000 versus yen258,000). In-hospital cost (yen1,202,891 +/- 208,793 versus yen1,050,280 +/- 177,984, P < 0.01) was higher in patients treated with SES. Less target lesion revascularization (4% versus 20%, P = 0.2) in patients with SES reduced the difference; aggregate 1-year cost was not significantly different (yen1,479,481 +/- 284,343 versus yen1,463,640 +/- 495,803, P = 0.9). It is concluded that SES may be cost-effective even in Japan.
Sugimoto
Kazumasa
K
Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Chuo-ku, Chiba, Chiba, Japan.
Kobayashi
Yoshio
Y
Kuroda
Nakabumi
N
Komuro
Issei
I
D000368:Aged; D003365:Costs and Cost Analysis; D054855:Drug-Eluting Stents / Q000191:economics*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D009313:National Health Programs / Q000191:economics; D019919:Prosthesis Implantation / Q000191:economics; D020123:Sirolimus / Q000008:administration & dosage*
D020123:Sirolimus