title: Cost-effectiveness of drug-eluting vs. bare-metal stents in patients with coronary artery disease from the Korean National Health Insurance Database.
abstract: OBJECTIVE
  The aim of this study was to evaluate the cost-effectiveness of the use of drug-eluting stents (DESs), as compared with bare-metal stents (BMSs) in Korea.
  
  
  METHODS
  A retrospective cohort study was conducted between January 2000 and December 2007. Subjects were stent-treated for the first time between 2004 and 2005, with four years of follow-up (2004-2007) (n=43674). The incremental cost-effectiveness ratio (ICER) was used to calculate the costs of DESs compared with BMSs among patients with coronary artery disease (CAD). Cost-effectiveness was assessed with effectiveness defined as a reduction in major adverse cardiac events after six months and after one, two, three, and four years.
  
  
  RESULTS
  The total costs of a DESs were 674108 Korean won (KRW) higher than that of a BMSs at the end of the follow-up; 13635 thousand KRW per patient treated with DESs and 12960 thousand KRW per patient treated with BMSs. The ICER was 256315 per KRW/death avoided and 293090 per KRW/re-stenting avoided among the CAD patients at the end of the follow-up.
  
  
  CONCLUSIONS
  The ICER for the high-risk patients was lower than that for the low-risk patients. The use of DESs is clinically more useful than the use of BMSs for CAD and myocardial infarction patients, especially for those considered to be high-risk patients in Korea.
authors.affiliation: Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea.
authors.forename: SooJin
authors.initials: S
authors.lastname: Lee
authors.affiliation: Division of Social Welfare, Baekseok University, Cheonan, Korea.
authors.forename: KyungWon
authors.initials: K
authors.lastname: Baek
authors.affiliation: Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea.; Graduate School of Public Health, Ajou University, Suwon, Korea. ajoujkh@ajou.ac.kr.
authors.forename: Kihong
authors.initials: K
authors.lastname: Chun
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D044466:Asian People / Q000706:statistics & numerical data; D003324:Coronary Artery Disease / Q000209:etiology / Q000628:therapy*; D003362:Cost-Benefit Analysis; D054855:Drug-Eluting Stents / Q000191:economics; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000191:economics*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy; D009313:National Health Programs / Q000706:statistics & numerical data*; D017239:Paclitaxel / Q000008:administration & dosage; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012306:Risk; D020123:Sirolimus / Q000008:administration & dosage; D015607:Stents / Q000009:adverse effects / Q000191:economics*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D017239:Paclitaxel; D020123:Sirolimus
keywords: Incremental cost effectiveness ratio; bare-metal stents; drug-eluting stents; stent implantation