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Moving beyond the cost per quality-adjusted life year: Modelling the budgetary impact and clinical outcomes associated with the use of sirolimus-eluting stents

Lookup NU author(s): Dr Fiona Shrive, Professor Cam Donaldson

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Abstract

Restenosis is a major limitation to the long-term success of percutaneous coronary intervention. Drug-eluting stents are the most recent technological advance in restenosis prevention. While they are effective, their use is associated with a significant incremental cost, and a recent economic evaluation performed by the authors suggested that their use is associated with a cost per quality-adjusted life year of $58,721. How should decision-makers react to this value, particularly given that the use of sirolimus-eluting stents appears more attractive in certain patient subgroups, such as those with complex coronary lesions? In the present paper, the authors explore an alternative method of presenting the results of their economic evaluation, rather than the usual cost per quality-adjusted life year rubric, in an attempt to assist decision-makers in deciding whether, and for whom, to fund sitolimus-eluting stents. Several issues that decision-makers and providers may wish to consider when making such funding decisions are discussed. © 2005 Pulsus Group Inc. All rights reserved.

Publication metadata

Author(s): Shrive FM, Ghali WA, Lewis S, Donaldson C, Knudtson ML, Manns BJ

Publication type: Article

Publication status: Published

Journal: Canadian Journal of Cardiology

Year: 2005

Volume: 21

Issue: 9

Pages: 783-787

Print publication date: 01/07/2005

ISSN (print): 0828-282X

ISSN (electronic): 1916-7075

Publisher: Pulsus

URL: http://www.pulsus.com/journals/abstract.jsp?sCurrPg=abstract&jnlKy=1&atlKy=893&isuKy=131&isArt=t&fromfold=

PubMed id: 16082437

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