What does this research mean for the field?

Coronary artery bypass grafting (CABG) is more cost-effective and leads to greater resource savings than percutaneous coronary intervention (PCI) with drug-eluting stents from the patient's perspective. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

February 15, 2023Cost Effectiveness and Resource AllocationOpen Access

Cost-effectiveness analysis of coronary arteries bypass grafting (CABG) and percutaneous coronary intervention (PCI) through drug stent in iran: a comparative study

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Why the study?

Coronary artery disease is a primary health concern worldwide, and cost-effectiveness analysis is needed to evaluate CABG versus PCI through drug stent using the QALY index.

Is CABG more cost-effective than PCI with drug-eluting stents in patients with coronary artery disease?

Structured PICO

Is CABG more cost-effective than PCI with drug-eluting stents in patients with coronary artery disease?

Population

410 patients undergoing CABG and PCI through drug stent in south of Iran

Intervention

Coronary Arteries Bypass Grafting (CABG)

Comparator

Percutaneous Coronary Intervention (PCI) through drug stent

Outcome

Cost-effectiveness using Quality-Adjusted Life Years (QALY) indexpatient reported

In an Iranian cohort, CABG was found to be more cost-effective than PCI with drug-eluting stents, leading to greater resource savings.

Implication

Should not yet change practice; extends observational cost data but leaves randomized confirmation open.

Abstract

BACKGROUND: Cost-effectiveness analysis plays a key role in evaluating health systems and services. Coronary artery disease is one of the primary health concerns worldwide. This study sought to compare the cost-effectiveness of Coronary Arteries Bypass Grafting (CABG) and Percutaneous Coronary Intervention (PCI) through drug stent using Quality-Adjusted Life Years (QALY) index. METHODS: This is a cohort study involving all patients undergoing CABG and PCI through drug stent in south of Iran. A total of 410 patients were randomly selected to be included in the study. Data were gathered using SF-36, SAQ and a form for cost data from the patients' perspective. The data were analyzed descriptively and inferentially. Considering the analysis of cost-effectiveness, Markov Model was initially developed using TreeAge Pro 2020. Both deterministic and probabilistic sensitivity analyses were performed. RESULTS: Compared with the group treated with PCI, the total cost of interventions was higher in the CABG group ($102,103.8 vs $71,401.22) and the cost of lost productivity ($20,228.68 vs $7632.11), while the cost of hospitalization was lower in CABG ($67,567.1 vs $49,660.97). The cost of hotel stay and travel ($6967.82 vs $2520.12) and the cost of medication ($7340.18 vs $11,588.01) was lower in CABG. From the patients' perspective and SAQ instrument, CABG was cost-saving, with a reduction of $16,581 for every increase in effectiveness. Based on patients' perspective and SF-36 instrument, CABG was cost-saving, with a reduction of $34,543 for every increase in effectiveness. CONCLUSION: In the same indications, CABG intervention leads to more resource savings.