1National Evidence-based Healthcare Collaborating Agency, Seoul, Korea.
2College of Pharmacy and Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, Korea.
3School of Pharmacy, Sungkyunkwan University, Suwon, Korea.
4Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
Copyright © 2013 The Korean Society for Preventive Medicine
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Model parameters | Types of initial stenting procedure |
Probabilistic model distribution | Source | |||||
---|---|---|---|---|---|---|---|---|
DES |
BMS |
|||||||
Values in base model | Ranges for sensitivity analyses |
Values in base model | Ranges for sensitivity analyses |
|||||
Low | High | Low | High | |||||
Probabilities (%) | ||||||||
TVR | 5.4 | 4.1 | 6.8 | 11.8 | 8.8 | 14.7 | Triangular | [6] |
DES | 59.7 | 44.8 | 74.6 | 50.9 | 38.1 | 63.6 | Triangular | HIRA claims data |
BMS | 0.6 | 0.5 | 0.8 | 3.4 | 2.6 | 4.3 | Triangular | |
CABG | 4.3 | 3.2 | 5.4 | 9.5 | 7.1 | 11.9 | Triangular | |
Balloon | 35.3 | 26.5 | 44.2 | 36.2 | 27.2 | 45.3 | Triangular | |
No TVR | 94.6 | 70.9 | 100.0 | 88.2 | 66.2 | 100.0 | Triangular | [6] |
Costs |
||||||||
TVR | HIRA claims data, [7,8,10] | |||||||
DES | 16 952 | 13 115 | 20 790 | 16 718 | 10 787 | 22 650 | Gamma | |
BMS | 16 415 | 13 209 | 19 620 | 13 422 | 10 798 | 16 047 | Gamma | |
CABG | 31 290 | 20 281 | 42 299 | 25 559 | 19 372 | 31 746 | Gamma | |
Balloon | 17 232 | 12 776 | 21 689 | 13 571 | 9779 | 17 364 | Gamma | |
No TVR | 10 688 | 6667 | 14 710 | 8760 | 5361 | 12 159 | Gamma |
Total costs incurred in patients with DES | Total costs incurred in patients with BMS | Cost difference between DES and BMS | |
---|---|---|---|
Dataset I (STEMI patients defined by ICD-10 code 21 with emergency visits) | |||
Total of two years | 11 065 528 | 9 647 647 | 1 417 882 |
1st year | 10 884 425 | 9 463 717 | 1 420 708 |
2nd year | 495 111 | 519 644 | -24 532 |
Dataset II (STEMI patients defined by ICD-10 code 21.9) | |||
Total of two years | 10 955 336 | 9 464 538 | 1 490 798 |
1st year | 10 782 129 | 9 254 967 | 1 527 162 |
2nd year | 509 317 | 558 718 | -49 401 |
Dataset I (subgroup analysis: patients inserted with only one stent) | |||
Total of two years | 10 368 612 | 9 550 778 | 817 833 |
1st year | 10 181 185 | 9 375 947 | 805 239 |
2nd year | 505 721 | 507 601 | -1880 |
Dataset I (using real-world data in Korean |
|||
Total of two years | 11 168 523 | 10 424 015 | 744 508 |
1st year | 10 962 470 | 10 116 455 | 846 015 |
2nd year | 537 937 | 746 531 | -208 594 |
DES, drug-eluting stents; BMS, bare-metal stents; TVR, target vessel revascularizations; CABG, coronary artery bypass graft; KRW, Korean won; HIRA, Health Insurance Review and Assessment; Balloon, balloon angioplasty. HIRA claims database, which is population-based data that contains information on all medical and prescription drug claim records of the Korean population (results from dataset I are presented). Two-year aggregate costs consisted of costs paid by national health insurance, copayments paid by patients, uninsured costs, and non-medical direct costs in 2011 KRW.
Values are presented as KRW/person. DES, drug-eluting stents; KRW, 2011 Korean won; BMS, bare-metal stents; STEMI, ST-segment elevation myocardial infarction; ICD-10, International Classification of Diseases tenth revision. The rate of target vessel revascularization from Park et al. [