Cost analysis between stent and conventional balloon angioplasty

Area of Science:

• Cardiovascular Medicine
• Health Economics
• Interventional Cardiology

Background:

• Coronary artery disease management often involves percutaneous coronary intervention.
• Comparing the economic implications of different revascularization strategies is crucial for healthcare resource allocation.

Purpose of the Study:

• To evaluate and compare the costs associated with coronary stenting versus conventional balloon angioplasty in Japan.
• To analyze the cost-effectiveness of stenting considering procedural and follow-up expenses.

Main Methods:

• Cost estimation included procedural fees, device costs (stents, balloons), hospital stay (7 days), and diagnostic tests.
• Data from the Stent Restenosis Study (STRESS) on device usage and target lesion revascularization (TLR) rates were utilized.
• Follow-up costs were calculated based on differential TLR rates (21% for balloon angioplasty, 15% for stenting).

Main Results:

• In-hospital costs were higher for stenting (Yen 1,416,893) compared to balloon angioplasty (Yen 982,300).
• Overall costs, including follow-up, were Yen 1,564,238 for stenting and Yen 1,188,583 for balloon angioplasty.
• Higher initial device costs for stenting contributed significantly to its increased expense, partially offset by lower revascularization rates.

Conclusions:

• Coronary stenting incurs higher in-hospital costs than conventional balloon angioplasty, primarily due to device expenses.
• While lower target lesion revascularization rates for stenting reduce long-term costs, the initial higher expenditure is not fully compensated.
• Economic considerations remain important when selecting between coronary stenting and balloon angioplasty in Japan.