title: Preliminary report on a cost-utility analysis of revascularization by percutaneous coronary intervention for ischemic heart disease.
abstract: Few socioeconomic studies have so far reported on revascularization for stable ischemic heart disease in Japan. This study aimed to validate the sensitivity of the health-related quality of life (HRQOL) scale for determining the pathology and medical technology to be used and to validate the application of a cost-utility analysis model. We studied 32 patients who had undergone percutaneous coronary intervention (PCI) (mean age 67.9 ± 7.3 years). For HRQOL, utility and quality of life (QOL) were examined using the EuroQol 5 Dimension (EQ-5D) and EuroQol Visual Analogue Scale (EQ-VAS), respectively. The changes in the utility index before and after PCI were compared between the PCI and coronary angiography (CAG) groups to determine the sensitivity of the EQ-5D that was used to calculate quality-adjusted life years (QALY). Additionally, to estimate the cost-utility of PCI 120 months after the procedure, we analyzed our study results and the results of previous reports using the Markov chain model. The utility index was found to improve in the PCI group (0.08 ± 0.15), whereas it decreased in the CAG group (-0.02 ± 0.11) (p = 0.049). The estimated result of the cost-utility analysis as the increase in utility above baseline level was the expected value, that is, 70,000 US$/QALY. Our findings suggest that QALY may be valid as a utility index in the clinical and economic evaluation of PCI in Japan.
authors.affiliation: Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka, 565-0871, Japan. takura@heip.med.osaka-u.ac.jp.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Takura
authors.affiliation: Department of Advanced Cardiovascular Therapeutics, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kouichi
authors.initials: K
authors.lastname: Tachibana
authors.affiliation: Ageo Central General Hospital, Saitama, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Isshiki
authors.affiliation: Department of Advanced Cardiovascular Therapeutics, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Sumitsuji
authors.affiliation: Department of Advanced Cardiovascular Therapeutics, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kuroda
authors.affiliation: Department of Advanced Cardiovascular Therapeutics, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Isamu
authors.initials: I
authors.lastname: Mizote
authors.affiliation: Department of Advanced Cardiovascular Therapeutics, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Seiko
authors.initials: S
authors.lastname: Ide
authors.affiliation: Department of Advanced Cardiovascular Therapeutics, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Nanto
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000191:economics / Q000601:surgery*; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006801:Humans; D007564:Japan; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000191:economics*; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D015203:Reproducibility of Results; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
keywords: Coronary artery disease; Cost-utility analysis; EuroQol-5 dimension; Markov chain model; Quality-adjusted life year