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Open Access 29-10-2024 | Everolimus | Original Research Article

Cost-Effectiveness of Three Different New-Generation Drug-Eluting Stents in the Randomised BIO-RESORT Trial at 3 Years

Authors: Eline H. Ploumen, Martijn J. Oude Wolcherink, Rosaly A. Buiten, Tineke H. Pinxterhuis, Carine J. M. Doggen, Carl E. Schotborgh, Peter W. Danse, Martijn Scholte, K. Gert van Houwelingen, Paolo Zocca, Xavier G. L. V. Pouwels, Clemens von Birgelen

Published in: PharmacoEconomics - Open

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Abstract

Background and Objective

Evidence on health economic outcomes for percutaneous coronary intervention (PCI) comparing different contemporary drug-eluting stents (DES) with each other is scarce, as most previous randomised DES trials did not assess such aspects. This prespecified health economic evaluation of the Comparison of Biodegradable Polymer and Durable Polymer Drug-Eluting Stents in an All Comers Population (BIO-RESORT) trial aimed to compare at 3-year follow-up both health effects and costs of PCI with one of three new-generation drug-eluting stents (DES) in patients with obstructive coronary artery disease.

Methods

The randomised BIO-RESORT trial assessed in 3514 patients the ultrathin-strut biodegradable polymer Orsiro sirolimus-eluting stent (SES) and very-thin-strut Synergy everolimus-eluting (EES) stent versus the thin-strut durable polymer Resolute Integrity zotarolimus-eluting stent (ZES). In the current analysis, we used the perspective of a health insurer in the Netherlands. The main endpoints were quality-adjusted life years (QALYs), and costs for each treatment strategy. Bootstrapping with 5000 resamples was performed to capture the uncertainty of results.

Results

Mean QALYs for each stent group were 2.566 for the SES, 2.551 for the EES, and 2.550 for the ZES. Mean costs per strategy were €14,670 for the SES, €14,946 for the EES, and €15,069 for the ZES. The SES had the highest probability of being cost-effective for every willingness-to-pay threshold up to €100,000 per QALY. Furthermore, in 79% of modelling scenarios, the SES was more effective and cheaper than ZES.

Conclusion

At 3-year follow-up, PCI with the SES had the highest probability of being cost-effective due to greater effectiveness and lower costs compared with the ZES and EES. These findings suggest that, due to the overall high volume of coronary stenting in clinical practice, use of this SES could result in substantial cost savings, complemented by slight additional health benefits.
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Metadata
Title
Cost-Effectiveness of Three Different New-Generation Drug-Eluting Stents in the Randomised BIO-RESORT Trial at 3 Years
Authors
Eline H. Ploumen
Martijn J. Oude Wolcherink
Rosaly A. Buiten
Tineke H. Pinxterhuis
Carine J. M. Doggen
Carl E. Schotborgh
Peter W. Danse
Martijn Scholte
K. Gert van Houwelingen
Paolo Zocca
Xavier G. L. V. Pouwels
Clemens von Birgelen
Publication date
29-10-2024
Publisher
Springer International Publishing
Keyword
Everolimus
Published in
PharmacoEconomics - Open
Print ISSN: 2509-4262
Electronic ISSN: 2509-4254
DOI
https://doi.org/10.1007/s41669-024-00539-x