Coronary Bypass Surgery Versus Percutaneous Coronary Intervention: Cost-Effectiveness in Iran: a Study In Patients With Multivessel Coronary Artery Disease

Mehdi Javanbakht, Razieh Yazdani Bakhsh, Atefeh Mashayekhi, Hossein Ghaderi, Masoumeh Sadeghi

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objectives: The aim of this study was to evaluate cost effectiveness of coronary artery bypass graft (CABG) versus percutaneous coronary intervention (PCI) with stenting from Iran society perspective. Methods: A retrospective study was carried out to estimate the annual cost and health related quality of life (HRQoL) of 109 patients who underwent coronary revascularization (PCI [n = 75] and CABG [n = 34]). A Markov model has been developed to determine the cost effectiveness of CABG compared with PCI. We used the model to calculate lifetime costs, life-years (LYs), and quality-adjusted life-years (QALYs) of each strategy. We also used probabilistic sensitivity analysis to test model robustness. Results: We found that discounted QALY lived per person in CABG versus PCI group in 5 years, 10 years, and lifetime time horizon were (3.8 ± 0.13 versus 3.88 ± 0.14), (6.4 ± 0.23 versus 6.33 ± 0.22), and (8.74 ± 0.29 versus 8.33 ± 0.27), respectively. The estimated medical cost of CABG and PCI per patient in 5 years, 10 years, and lifetime time horizon were (USD 6,819 ± 765 versus 9,011 ± 1,816), (USD 8,852 ± 1,348 versus 12,034 ± 2,375), and (USD 14,037± 4,201 versus 18,798 ± 5,821), respectively. The incremental cost-effectiveness ratio results showed CABG is a dominate alternative in 10 years and lifetime time horizon. Conclusions: This study demonstrated that despite higher initial cost and lower HRQoL, CABG is a cost-effective revascularization strategy compared with PCI for patients with multivessel coronary artery disease in long-term.

Original languageEnglish
Pages (from-to)366-373
Number of pages8
JournalInternational Journal of Technology Assessment in Health Care
Volume30
Issue number4
DOIs
Publication statusPublished - Oct 2014

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Percutaneous Coronary Intervention
Iran
Coronary Artery Bypass
Cost-Benefit Analysis
Coronary Artery Disease
Transplants
Costs and Cost Analysis
Quality-Adjusted Life Years
Quality of Life
Retrospective Studies

Keywords

  • cost effectiveness analysis
  • percutaneous coronary intervention
  • coronary artery bypass grafting
  • Iran
  • quality adjusted life years

Cite this

Coronary Bypass Surgery Versus Percutaneous Coronary Intervention : Cost-Effectiveness in Iran: a Study In Patients With Multivessel Coronary Artery Disease. / Javanbakht, Mehdi; Bakhsh, Razieh Yazdani; Mashayekhi, Atefeh; Ghaderi, Hossein; Sadeghi, Masoumeh.

In: International Journal of Technology Assessment in Health Care, Vol. 30, No. 4, 10.2014, p. 366-373.

Research output: Contribution to journalArticle

Javanbakht, Mehdi ; Bakhsh, Razieh Yazdani ; Mashayekhi, Atefeh ; Ghaderi, Hossein ; Sadeghi, Masoumeh. / Coronary Bypass Surgery Versus Percutaneous Coronary Intervention : Cost-Effectiveness in Iran: a Study In Patients With Multivessel Coronary Artery Disease. In: International Journal of Technology Assessment in Health Care. 2014 ; Vol. 30, No. 4. pp. 366-373.
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title = "Coronary Bypass Surgery Versus Percutaneous Coronary Intervention: Cost-Effectiveness in Iran: a Study In Patients With Multivessel Coronary Artery Disease",
abstract = "Objectives: The aim of this study was to evaluate cost effectiveness of coronary artery bypass graft (CABG) versus percutaneous coronary intervention (PCI) with stenting from Iran society perspective. Methods: A retrospective study was carried out to estimate the annual cost and health related quality of life (HRQoL) of 109 patients who underwent coronary revascularization (PCI [n = 75] and CABG [n = 34]). A Markov model has been developed to determine the cost effectiveness of CABG compared with PCI. We used the model to calculate lifetime costs, life-years (LYs), and quality-adjusted life-years (QALYs) of each strategy. We also used probabilistic sensitivity analysis to test model robustness. Results: We found that discounted QALY lived per person in CABG versus PCI group in 5 years, 10 years, and lifetime time horizon were (3.8 ± 0.13 versus 3.88 ± 0.14), (6.4 ± 0.23 versus 6.33 ± 0.22), and (8.74 ± 0.29 versus 8.33 ± 0.27), respectively. The estimated medical cost of CABG and PCI per patient in 5 years, 10 years, and lifetime time horizon were (USD 6,819 ± 765 versus 9,011 ± 1,816), (USD 8,852 ± 1,348 versus 12,034 ± 2,375), and (USD 14,037± 4,201 versus 18,798 ± 5,821), respectively. The incremental cost-effectiveness ratio results showed CABG is a dominate alternative in 10 years and lifetime time horizon. Conclusions: This study demonstrated that despite higher initial cost and lower HRQoL, CABG is a cost-effective revascularization strategy compared with PCI for patients with multivessel coronary artery disease in long-term.",
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author = "Mehdi Javanbakht and Bakhsh, {Razieh Yazdani} and Atefeh Mashayekhi and Hossein Ghaderi and Masoumeh Sadeghi",
note = "Footnotes The authors thank all participants in the study. This work was supported partially by Tehran University of Medical Sciences [grant number 34123].",
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TY - JOUR

T1 - Coronary Bypass Surgery Versus Percutaneous Coronary Intervention

T2 - Cost-Effectiveness in Iran: a Study In Patients With Multivessel Coronary Artery Disease

AU - Javanbakht, Mehdi

AU - Bakhsh, Razieh Yazdani

AU - Mashayekhi, Atefeh

AU - Ghaderi, Hossein

AU - Sadeghi, Masoumeh

N1 - Footnotes The authors thank all participants in the study. This work was supported partially by Tehran University of Medical Sciences [grant number 34123].

PY - 2014/10

Y1 - 2014/10

N2 - Objectives: The aim of this study was to evaluate cost effectiveness of coronary artery bypass graft (CABG) versus percutaneous coronary intervention (PCI) with stenting from Iran society perspective. Methods: A retrospective study was carried out to estimate the annual cost and health related quality of life (HRQoL) of 109 patients who underwent coronary revascularization (PCI [n = 75] and CABG [n = 34]). A Markov model has been developed to determine the cost effectiveness of CABG compared with PCI. We used the model to calculate lifetime costs, life-years (LYs), and quality-adjusted life-years (QALYs) of each strategy. We also used probabilistic sensitivity analysis to test model robustness. Results: We found that discounted QALY lived per person in CABG versus PCI group in 5 years, 10 years, and lifetime time horizon were (3.8 ± 0.13 versus 3.88 ± 0.14), (6.4 ± 0.23 versus 6.33 ± 0.22), and (8.74 ± 0.29 versus 8.33 ± 0.27), respectively. The estimated medical cost of CABG and PCI per patient in 5 years, 10 years, and lifetime time horizon were (USD 6,819 ± 765 versus 9,011 ± 1,816), (USD 8,852 ± 1,348 versus 12,034 ± 2,375), and (USD 14,037± 4,201 versus 18,798 ± 5,821), respectively. The incremental cost-effectiveness ratio results showed CABG is a dominate alternative in 10 years and lifetime time horizon. Conclusions: This study demonstrated that despite higher initial cost and lower HRQoL, CABG is a cost-effective revascularization strategy compared with PCI for patients with multivessel coronary artery disease in long-term.

AB - Objectives: The aim of this study was to evaluate cost effectiveness of coronary artery bypass graft (CABG) versus percutaneous coronary intervention (PCI) with stenting from Iran society perspective. Methods: A retrospective study was carried out to estimate the annual cost and health related quality of life (HRQoL) of 109 patients who underwent coronary revascularization (PCI [n = 75] and CABG [n = 34]). A Markov model has been developed to determine the cost effectiveness of CABG compared with PCI. We used the model to calculate lifetime costs, life-years (LYs), and quality-adjusted life-years (QALYs) of each strategy. We also used probabilistic sensitivity analysis to test model robustness. Results: We found that discounted QALY lived per person in CABG versus PCI group in 5 years, 10 years, and lifetime time horizon were (3.8 ± 0.13 versus 3.88 ± 0.14), (6.4 ± 0.23 versus 6.33 ± 0.22), and (8.74 ± 0.29 versus 8.33 ± 0.27), respectively. The estimated medical cost of CABG and PCI per patient in 5 years, 10 years, and lifetime time horizon were (USD 6,819 ± 765 versus 9,011 ± 1,816), (USD 8,852 ± 1,348 versus 12,034 ± 2,375), and (USD 14,037± 4,201 versus 18,798 ± 5,821), respectively. The incremental cost-effectiveness ratio results showed CABG is a dominate alternative in 10 years and lifetime time horizon. Conclusions: This study demonstrated that despite higher initial cost and lower HRQoL, CABG is a cost-effective revascularization strategy compared with PCI for patients with multivessel coronary artery disease in long-term.

KW - cost effectiveness analysis

KW - percutaneous coronary intervention

KW - coronary artery bypass grafting

KW - Iran

KW - quality adjusted life years

U2 - 10.1017/S0266462314000439

DO - 10.1017/S0266462314000439

M3 - Article

C2 - 25401422

VL - 30

SP - 366

EP - 373

JO - International Journal of Technology Assessment in Health Care

JF - International Journal of Technology Assessment in Health Care

SN - 0266-4623

IS - 4

ER -