Key result
Absorb bioresorbable vascular scaffold yields similar 1-year health care costs versus Xience everolimus-eluting stent.
Why the study?
Whether health care costs differ between the Absorb bioresorbable vascular scaffold and the Xience everolimus-eluting stent in patients undergoing PCI was unknown.
Does the Absorb bioresorbable vascular scaffold reduce total 1-year health care costs compared to the Xience everolimus-eluting stent in patients undergoing percutaneous coronary intervention?
RCT (n=2,008)
randomized
Does the Absorb bioresorbable vascular scaffold reduce total 1-year health care costs compared to the Xience everolimus-eluting stent in patients undergoing percutaneous coronary intervention?
The Absorb bioresorbable vascular scaffold is associated with higher initial procedural costs but similar total 1-year health care costs compared to the Xience everolimus-eluting stent.
No 1-year cost savings with Absorb versus Xience; supports clinical rather than economic drivers for stent selection in PCI.
OBJECTIVES: The purpose of this study was to evaluate the economic impact of the Absorb bioresorbable vascular scaffold compared with the Xience everolimus-eluting stent in patients undergoing percutaneous coronary intervention. BACKGROUND: The ABSORB III trial (Everolimus-Eluting Bioresorbable Scaffolds for Coronary Artery Disease) demonstrated that the Absorb scaffold was noninferior to the Xience stent with respect to target lesion failure at 1 year. Whether health care costs differ between the Absorb scaffold and the Xience stent is unknown. METHODS: We performed a prospective health economic study alongside the ABSORB III trial, in which patients undergoing percutaneous coronary intervention for stable or unstable angina were randomized to receive the Absorb scaffold (n = 1,322) or Xience stent (n = 686). Resource use data were collected through 1 year of follow-up. Costs were assessed using resource-based accounting (for procedures), MedPAR data (for other index hospitalization costs), and Medicare reimbursements (for follow-up costs and physician fees). RESULTS: Initial procedural costs were higher with the Absorb scaffold than the Xience stent ($6,316 ± 1,892 vs. $6,103 ± 1,895; p = 0.02), driven mainly by greater balloon catheter use and the higher cost of the scaffold in the Absorb group. Nonetheless, index hospitalization costs ($15,035 ± 2,992 for Absorb vs. $14,903 ± 3,449 for Xience; p = 0.37) and total 1-year costs ($17,848 ± 6,110 for Absorb vs. $17,498 ± 7,411 for Xience; p = 0.29) were similar between the 2 groups. CONCLUSIONS: Although initial procedural costs were higher with the Absorb scaffold, there were no differences in total 1-year health care costs between the 2 cohorts. Longer term follow-up is needed to determine whether meaningful cost savings emerge after scaffold resorption. (A Clinical Evaluation of Absorb™ BVS, the Everolimus-Eluting Bioresorbable Vascular Scaffold in the Treatment of Subjects With de Novo Native Coronary Artery Lesions; NCT01751906).
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Baron et al. (2017) conducted an RCT in stable or unstable angina undergoing percutaneous coronary intervention (n=2,008). Absorb bioresorbable vascular scaffold vs. Xience everolimus-eluting stent was evaluated on Total 1-year health care costs (p=0.29). The Absorb bioresorbable vascular scaffold resulted in similar total 1-year health care costs compared with the Xience everolimus-eluting stent ($17,848 vs. $17,498; p=0.29).
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