| Stenting with a sirolimus-eluting stent (SES) dramatically reduces the risk of restenosiscompared to bare metal stent (BMS) implantation. However, before SES can be widely adopted inclinical practice, it is essential to conduct an economic evaluation of this effective but expensive device.Our study was undertaken to estimate the three-year cumulative medical costs of stenting using SEScompared to BMS. The data on clinical sequelae of stenting using BMS were derived from our previousstudy, based on data collected from three Japanese hospitals. We estimated that the probability ofPTCA required for revascularization would be 0.224 times in SES implantation compared than in BMSimplantation based on the SIRIUS study result. The medical costs for procedures were obtained frompublished articles and were adjusted to the March 2005 level. Our simulation showed the expectedthree-year cumulative medical cost per patient to be approximately ¥200,000 lower in the SES group(¥2,233,000) than in the BMS group (¥2,431,000). Sensitivity analyses with different presumptionsconfirmed that the economic advantage of SES over BMS was quite robust. We concluded that the useof SES would be a cost-saving option as compared with BMS implantation within the context of theJapanese healthcare system. |
