Annual cost of stable coronary artery disease in France: A modeling study.
Arch Cardiovasc Dis
; 108(11): 576-88, 2015 Nov.
Article
em En
| MEDLINE
| ID: mdl-26433733
ABSTRACT
BACKGROUND:
Few studies have analyzed the cost of treatment of chronic angina pectoris, especially in European countries.AIM:
To determine, using a modeling approach, the cost of care in 2012 for 1year of treatment of patients with stable angina, according to four therapeutic options optimal medical therapy (OMT); percutaneous coronary intervention with bare-metal stent (PCI-BMS); PCI with drug-eluting stent (PCI-DES); and coronary artery bypass graft (CABG).METHODS:
Six different clinical scenarios that could occur over 1year were defined clinical success; recurrence of symptoms without hospitalization; myocardial infarction (MI); subsequent revascularization; death from non-cardiac cause; and cardiac death. The probability of a patient being in one of the six clinical scenarios, according to the therapeutic options used, was determined from a literature search. A direct medical cost for each of the therapeutic options was calculated from the perspective of French statutory health insurance.RESULTS:
The annual costs per patient for each strategy, according to their efficacy results, were, in our models, 1567 with OMT, 5908 with PCI-BMS, 6623 with PCI-DES and 16,612 with CABG. These costs were significantly different (P<0.05). A part of these costs was related to management of complications (recurrence of symptoms, MI and death) during the year (between 3% and 38% depending on the therapeutic options studied); this part of the expenditure was lowest with the CABG therapeutic option.CONCLUSION:
OMT appears to be the least costly option, and, if reasonable from a clinical point of view, might achieve appreciable savings in health expenditure.Palavras-chave
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MEDLINE
Assunto principal:
Doença da Artéria Coronariana
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Fármacos Cardiovasculares
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Ponte de Artéria Coronária
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Custos de Cuidados de Saúde
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Gastos em Saúde
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Modelos Econômicos
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Angina Estável
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Intervenção Coronária Percutânea
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article