title: Economic Evaluation of the Use of Drug-Eluting Stents versus Bare-Metal Stents in Adults with Ischemic Cardiomyopathy Requiring Angioplasty.
abstract: BACKGROUND
  The value of drug-eluting stents in preventing cardiovascular events has not been investigated in Mexico.
  
  
  OBJECTIVE
  To conduct a cost-effectiveness analysis of early and new-generation drug-eluting stents from the perspective of a healthcare provider.
  
  
  METHODS
  We conducted a cost-effectiveness analysis of early and new-generation drug-eluting stents in patients with ischemic cardiomyopathy attending a Cardiology Hospital of the Mexican Social Security Institute. The health endpoint used was major acute cardiovascular events prevented. The effectiveness by stent type was obtained from the literature. A retrospective chart review study was conducted to collect cost data on cardiovascular events including seven cost categories. Average and incremental cost-effectiveness ratios were estimated. Deterministic and probabilistic sensitivity analyses were performed to test the robustness of estimates.
  
  
  RESULTS
  Incremental cost-effectiveness ratios in base-case were 28,910 and US$ 35,590 for early and new-generation stents, respectively. In an optimal scenario, incremental-cost effectiveness ratio was 24,776 and US$ 25,262 for early and new stents, respectively. Probabilistic sensitivity analysis suggested that 90% of cases were cost-effective when willingness-to-pay was 58,000 and US$ 66,000 for early and new-generation stents, respectively.
  
  
  CONCLUSIONS
  The cost-effectiveness ratios of early and new-generation stents were significantly higher than corresponding bare-metal stents.
authors.affiliation: Department of Hemodynamics, Hospital de Cardiología, Unidad Médica de Alta Especialidad, CMN-SXXI, Instituto Mexicano del Seguro Social (IMSS), México, D.F., México.
authors.forename: Belinda
authors.initials: B
authors.lastname: González-Díaz
authors.affiliation: Department of Investigation, Hospital Infantil de México Federico Gómez, México, D.F., México.
authors.forename: Juan
authors.initials: J
authors.lastname: Garduño-Espinosa
authors.affiliation: Center for Economic and Social Studies in Health, Hospital Infantil de México Federico Gómez, México, D.F., México.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Salinas-Escudero
authors.affiliation: Center for Economic and Social Studies in Health, Hospital Infantil de México Federico Gómez, México, D.F., México.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Reyes-López
authors.affiliation: Department for Epidemiological Investigation and Health Services, Aging Area, CMN-SXXI, IMSS, México, D.F., México.
authors.forename: Víctor
authors.initials: V
authors.lastname: Granados-García
mesh_terms: D017130:Angioplasty / Q000191:economics / Q000379:methods; D009202:Cardiomyopathies / Q000191:economics / Q000628:therapy*; D003362:Cost-Benefit Analysis; D054855:Drug-Eluting Stents / Q000191:economics; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000191:economics / Q000628:therapy*; D012189:Retrospective Studies; D015607:Stents / Q000191:economics; D016896:Treatment Outcome