Cost‐Effectiveness of Drug‐Coated Balloons in the Treatment of Coronary Small Vessel Disease: A Report From the BASKET‐SMALL 2 Randomized Controlled Trial

Figures

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  Figure 1. State‐transition graph of the Markov cohort discrete‐time model. MI indicates myocardial infarction; and TVR, target vessel revascularization.

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  Figure 2. Breakdown of expected costs, in EUR. DAPT indicates dual antiplatelet therapy; DCB, drug‐coated balloon; DES, drug‐eluting stent; EES, everolimus‐eluting stent; MI, myocardial infarction; PCI, percutaneous coronary intervention; and TVR, target vessel revascularization.

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  Figure 3. Probabilistic sensitivity analyses. DCB vs DES over 3‐year (A) and 5‐year (B) time horizons, as well as DCB vs EES over 3‐year (C) and 5‐year (D) time horizons, respectively, with a cost‐effectiveness threshold of 30 000 EUR per QALY gained applied. Percentages give frequencies of samples in each quadrant (upper right of panels A, B, C, and D: DCB more effective but more expensive than DES/EES; upper left of panels A, B, C, and D: DCB dominated by DES/EES, because less effective and more expensive; lower left of panels A, B, C, and D: DCB less effective but less expensive than DES/EES; lower right of panels A, B, C, and D: DCB dominating DES/EES, because more effective and less expensive). DCB indicates drug‐coated balloon; DES, drug‐eluting stent; EES, everolimus‐eluting stent; and QALY, quality‐adjusted life‐year.

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  Figure 4. Probabilistic sensitivity analyses. DCB vs DES over 3‐year (A) and 5‐year (B) time horizons, as well as DCB vs EES over 3‐year (C) and 5‐year (D) time horizons, respectively, with a cost‐effectiveness threshold example of 30 000 EUR per QALY gained. DCB indicates drug‐coated balloon; DES, drug‐eluting stent; EES, everolimus‐eluting stent; and QALY, quality‐adjusted life‐year.

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  Figure 5. One‐way deterministic sensitivity analyses. Variability of the difference between DCB and DES in net monetary benefit at 3 years (in EUR), when the estimated event risks vary over their 95% CIs, favoring DCB (blue) or DES (orange). Net monetary benefit is the value of the quality‐adjusted life expectancy (at 30 000 EUR per QALY) minus the expected costs: at 3 years it is 330 EUR lower for DCB than for DES, according to the BASKET‐SMALL 2 event risks. BASKET‐SMALL 2 indicates Basel Stent Kosten‐Effektivitäts Trial: Drug‐Coated Balloons Versus Drug‐Eluting Stents in Small Vessel Interventions 2; DCB, drug‐coated balloon; DES, drug‐eluting stent; MI, myocardial infarction; QALY, quality‐adjusted life‐year; and TVR, target vessel revascularization.