title: Cost analysis of four major drug-eluting stents in diabetic populations.
abstract: OBJECTIVE
  To use an indirect comparisons approach and conduct a cost analysis comparing four drug-eluting stents (DES) from a United States (US) payer (i.e., fixed-fee reimbursement) perspective.
  
  
  RESULTS
  Studies were chosen that randomised two or more DES in diabetic patients. A one-year target lesion revascularisation (TLR) risk for Taxus was first derived. Risk Ratios (RRs) for each DES versus Taxus were calculated through meta-analyses. The RRs were multiplied by the average TLR risk for Taxus to estimate DES TLR risks. Estimates were added to a budget-impact model, along with utilisation and reimbursement rates for diagnosis-related groups. Budgets were calculated, assuming 100% stent use and 200,000 diabetic beneficiaries. One-year TLR risks were estimated to be 3.2%, 7.1%, 6.9% and 7.9% for Cypher, Endeavor, Taxus and Xience respectively. By substituting Cypher for DES with higher TLR, results predicted annual cost-savings greater than $146 million per population ($ 733 per patient). Results were comparable when assuming no difference in TLR risk between Endeavor, Taxus and Xience.
  
  
  CONCLUSIONS
  When outcomes from trials of diabetic populations are analysed and used in a budget-impact model from a US payer perspective, the use of Cypher is associated with lower TLR rates, which translates into large potential cost savings.
authors: Cordis Corporation, Bridgewater New Jersey, USA.
authors: Ryan
authors: R
authors: Saadi
authors: Sidney
authors: S
authors: Cohen
authors: David
authors: D
authors: Banko
authors: Melissa
authors: M
authors: Thompson
authors: Michael
authors: M
authors: Duong
authors: Nicole
authors: N
authors: Ferko
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D003324:Coronary Artery Disease / Q000209:etiology* / Q000628:therapy*; D023903:Coronary Restenosis / Q000453:epidemiology; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D048909:Diabetes Complications / Q000150:complications*; D054855:Drug-Eluting Stents / Q000145:classification* / Q000191:economics*; D006801:Humans; D016017:Odds Ratio; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States