The Impact of Optimal Stenting Techniques on Cardiac Catheterization Laboratory Resource Utilization and Costs

Sukin, Craig A; Baim, Donald S.; Caputo, Ronald P.; Ho, Kalon K.L.; Laham, Roger J.; Flatley, Margaret; Carrozza, Joseph P.; Cohen, David J.

doi:10.1016/s0002-9149(96)00747-3

Cited by 21 publications

(7 citation statements)

References 17 publications

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“…185 In the BENESTENT 2 trial, which used the heparin-coated Palmaz-Schatz stent and the current dual antiplatelet-antithrombotic regimen, 39 initial hospital costs remained more than $2000 (£1243) higher with stenting than with balloon angioplasty [$10,376 (£6447) versus $8198 (£5094), An economic evaluation of coronary stenting was also performed in conjunction with the Evaluation of Platelet IIb/IIIa Inhibitor for STENTing (EPISTENT) trial that compared three strategies of percutaneous coronary revascularisation. As was seen in the previous randomised trials, stenting increased initial hospital costs by $1900 (£1181) per patient and did not fully 'pay for itself ' by 1-year follow-up.…”

Section: Stents Versus Balloon Angioplastymentioning

confidence: 99%

Coronary artery stents: a rapid systematic review and economic evaluation

Hill¹,

Bagust²,

Bakhai³

et al. 2004

Health Technol Assess

144

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Section: Stents Versus Balloon Angioplastymentioning

confidence: 99%

Coronary artery stents: a rapid systematic review and economic evaluation

Hill¹,

Bagust²,

Bakhai³

et al. 2004

Health Technol Assess

144

View full text Add to dashboard Cite

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“…The clinical outcome in OPUS differed from the outcome in FROST; patients with routine stenting experienced less event than patients with provisional stenting,although the populations were comparable. Other costs for the initial procedure in the USA have been reported; differences with French costs are explained by higher costs of stents [12,13,14,15,16], more restrictive use of stents in France, and lower physician costs ($1,300 in the EPILOG study versus $400 in France) [17]. The average length of stay for patients in the USA was shorter than in Europe for typical candidates undergoing percutaneous revascularization.…”

Section: Estimation Of Costs In the United Statesmentioning

confidence: 99%

“…Unit cost of stents was varied using published data for hospital in the USA, from the current French price of $743-$2,450 [12,13,14,15].Procedural time for direct stenting was obtained from another study and estimated to be on average 24 min [19]. Because of the current developments regarding coated stents, we did not model the rate of restenosis, which used to be a key parameter in the decision but is now likely to become less relevant [20].…”

Section: Sensitivity Analysismentioning

confidence: 99%

A tale of two countries: costs and financial incentives for provisional stenting during percutaneous coronary intervention in France and the United States

Durand‐Zaleski

Dupouy²,

Carrié³

et al. 2002

The European Journal of Health Economics

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Provisional stenting is associated with longer physician time but the use of fewer stents. This randomized controlled trial in tertiary care in French hospitals compared strategies of systematic and provisional stenting. We estimated the costs and financial incentives associated with each strategy, based on individual data on 12-month resource use drawn from a 251-patient database. Resources were evaluated using French costs; data on costs in the United States were drawn from the literature and interviews with hospital administrators in one center. In France 1-year costs were 8,267+/-528 dollars for provisional stenting and 7,973+/-553 dollars for systematic stenting, compared to 18,715 dollars and 18,632 dollars in the United States. Given the uncertainty of longterm results, the choice between stenting strategies might be guided by financial incentives. In the United States financial incentives favor systematic stenting, while in France public hospitals and physicians are neutral.

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“…Sukin et al [30] evaluated the resource utilisation and cost impact of stenting in 78 patients with single, discrete coronary stenosis and 30 patients with either a long stenosis, or serial discrete lesions. The resultant resource use and cost implications for these patients were compared with patients participating in the economic sub-study of the Stent Restenosis Study (STRESS) [31], who underwent either planned singlevessel angioplasty or stenting.…”

Section: United Statesmentioning

confidence: 99%

“…As a comparison, the angioplasty group (n=105) had mean catheterisation laboratory costs of US$ 3,758 [30]. The authors indicated that a number of factors led to the higher cost of stenting at their centre compared to patients enrolled in the STRESS trial.While clearly the cost of procedure consumables changes over time, most interestingly, the authors note that routine stent optimisation techniques result (study conducted in 1995) in significantly increased balloon and stent use compared to patients in the STRESS trial [30]. These study results imply that the routine cost of stent procedures is higher than would be anticipated given existing published trial data.…”

Section: United Statesmentioning

confidence: 99%

International review of the utilisation and cost of percutaneous transluminal coronary angioplasty

Lecomte¹,

McKenna²,

Kennedy³

et al. 2001

The European Journal of Health Economics (HEPAC)

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We reviewed information published between 1990 and March 2001 to ascertain trends in the utilisation of percutaneous transluminal coronary angioplasty (PTCA) and to determine the availability of cost data.Our review encompassed Australia, Canada, France, Germany, Italy, Sweden, the United Kingdom, and the United States.The number of PTCAs increased in all countries studied during the 1990s.While the rate of PTCA use in all European countries lags behind that of the US, Germany and France are approaching the US rate, and the uptake of PTCA among European countries is increasing rapidly after a slow start.With regard to PTCA cost data, direct international comparisons are difficult since patient populations, methodological factors, and the timing and location of each study contributed to the differences observed between and within the studies reviewed. The increasing number of patients receiving PTCA emphasises the need for accurate cost data.

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The Impact of Optimal Stenting Techniques on Cardiac Catheterization Laboratory Resource Utilization and Costs

Cited by 21 publications

References 17 publications

Coronary artery stents: a rapid systematic review and economic evaluation

Coronary artery stents: a rapid systematic review and economic evaluation

A tale of two countries: costs and financial incentives for provisional stenting during percutaneous coronary intervention in France and the United States

International review of the utilisation and cost of percutaneous transluminal coronary angioplasty

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