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Published in: Clinical Research in Cardiology 7/2012

01-07-2012 | Original Paper

Cost-effectiveness of paclitaxel-coated balloon angioplasty and paclitaxel-eluting stent implantation for treatment of coronary in-stent restenosis in patients with stable coronary artery disease

Authors: Klaus Bonaventura, Alexander W. Leber, Christian Sohns, Mattias Roser, Leif-Hendrik Boldt, Franz X. Kleber, Wilhelm Haverkamp, Marc Dorenkamp

Published in: Clinical Research in Cardiology | Issue 7/2012

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Abstract

Background

Recent studies have demonstrated the safety and efficacy of drug-coated balloon (DCB) angioplasty for the treatment of coronary in-stent restenosis (ISR). The cost-effectiveness of this practice is unknown.

Methods

A Markov state-transition decision analytic model accounting for varying procedural efficacy rates, complication rates, and cost estimates was developed to compare DCB angioplasty with drug-eluting stent (DES) placement in patients with bare-metal stent (BMS)-ISR. Data on procedural outcomes associated with both treatment strategies were derived from the literature, and the cost analysis was conducted from a health care payer perspective. Effectiveness was expressed as life-years gained.

Results

In the base-case analysis, initial procedure costs amounted to €3,604.14 for DCB angioplasty and to €3,309.66 for DES implantation. Over a 12-month time horizon, the DCB strategy was found to be less costly (€4,130.38 vs. €5,305.30) and slightly more effective in terms of life expectancy (0.983 vs. 0.976 years) than the DES strategy. Extensive sensitivity analyses indicated that, in comparison with DES implantation, the cost advantage of the DCB strategy was robust to clinically plausible variations in the values of key model input parameters. The variables with the greatest impact on base-case results were the duration of dual antiplatelet therapy with acetylsalicylic acid and clopidogrel after DCB angioplasty, the use of generic clopidogrel, and variations in the costs associated with the DCB device.

Conclusion

DCB angioplasty is a cost-effective treatment option for coronary BMS-ISR. The higher initial costs of DCB are more than offset by later cost-savings, predominantly as a result of reduced medication costs.
Literature
1.
go back to reference Stone GW, Ellis SG, Cannon L, Mann JT, Greenberg JD, Spriggs D, O’Shaughnessy CD, DeMaio S, Hall P, Popma JJ, Koglin J, Russell ME, TAXUS V Investigators (2005) Comparison of a polymer-based paclitaxel-eluting stent with a bare metal stent in patients with complex coronary artery disease: a randomized controlled trial. JAMA 294:1215–1223PubMedCrossRef Stone GW, Ellis SG, Cannon L, Mann JT, Greenberg JD, Spriggs D, O’Shaughnessy CD, DeMaio S, Hall P, Popma JJ, Koglin J, Russell ME, TAXUS V Investigators (2005) Comparison of a polymer-based paclitaxel-eluting stent with a bare metal stent in patients with complex coronary artery disease: a randomized controlled trial. JAMA 294:1215–1223PubMedCrossRef
2.
go back to reference Tentzeris I, Jarai R, Farhan S, Wojta J, Schillinger M, Geppert A, Nürnberg M, Unger G, Huber K (2011) Long-term outcome after drug-eluting stent implantation in comparison with bare metal stents: a single centre experience. Clin Res Cardiol 100:191–200PubMedCrossRef Tentzeris I, Jarai R, Farhan S, Wojta J, Schillinger M, Geppert A, Nürnberg M, Unger G, Huber K (2011) Long-term outcome after drug-eluting stent implantation in comparison with bare metal stents: a single centre experience. Clin Res Cardiol 100:191–200PubMedCrossRef
3.
go back to reference de Waha A, Dibra A, Kufner S, Baumgart D, Sabate M, Maresta A, Schömig A, Kastrati A (2011) Long-term outcome after sirolimus-eluting stents versus bare metal stents in patients with diabetes mellitus: a patient-level meta-analysis of randomized trials. Clin Res Cardiol 100:561–570PubMedCrossRef de Waha A, Dibra A, Kufner S, Baumgart D, Sabate M, Maresta A, Schömig A, Kastrati A (2011) Long-term outcome after sirolimus-eluting stents versus bare metal stents in patients with diabetes mellitus: a patient-level meta-analysis of randomized trials. Clin Res Cardiol 100:561–570PubMedCrossRef
4.
go back to reference Clark MA, Bakhai A, Pelletier EM, Cohen DJ (2005) Clinical and economic effects of coronary restenosis after percutaneous coronary intervention in a managed care population. Manag Care 14:42–44, 46–51 Clark MA, Bakhai A, Pelletier EM, Cohen DJ (2005) Clinical and economic effects of coronary restenosis after percutaneous coronary intervention in a managed care population. Manag Care 14:42–44, 46–51
5.
go back to reference Wijns W, Kolh P, Danchin N, Di Mario C, Falk V, Folliguet T, Garg S, Huber K, James S, Knuuti J, Lopez-Sendon J, Marco J, Menicanti L, Ostojic M, Piepoli MF, Pirlet C, Pomar JL, Reifart N, Ribichini FL, Schalij MJ, Sergeant P, Serruys PW, Silber S, Sousa Uva M, Taggart D (2010) Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 31:2501–2555PubMedCrossRef Wijns W, Kolh P, Danchin N, Di Mario C, Falk V, Folliguet T, Garg S, Huber K, James S, Knuuti J, Lopez-Sendon J, Marco J, Menicanti L, Ostojic M, Piepoli MF, Pirlet C, Pomar JL, Reifart N, Ribichini FL, Schalij MJ, Sergeant P, Serruys PW, Silber S, Sousa Uva M, Taggart D (2010) Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 31:2501–2555PubMedCrossRef
6.
go back to reference Holmes DR Jr, Teirstein P, Satler L, Sketch M, O’Malley J, Popma JJ, Kuntz RE, Fitzgerald PJ, Wang H, Caramanica E, Cohen SA, SISR Investigators (2006) Sirolimus-eluting stents vs. vascular brachytherapy for in-stent restenosis within bare-metal stents: the SISR randomized trial. JAMA 295:1264–1273PubMedCrossRef Holmes DR Jr, Teirstein P, Satler L, Sketch M, O’Malley J, Popma JJ, Kuntz RE, Fitzgerald PJ, Wang H, Caramanica E, Cohen SA, SISR Investigators (2006) Sirolimus-eluting stents vs. vascular brachytherapy for in-stent restenosis within bare-metal stents: the SISR randomized trial. JAMA 295:1264–1273PubMedCrossRef
7.
go back to reference Kastrati A, Mehilli J, von Beckerath N, Dibra A, Hausleiter J, Pache J, Schuhlen H, Schmitt C, Dirschinger J, Schomig A, ISAR-DESIRE Study Investigators (2005) Sirolimus-eluting stent or paclitaxel-eluting stent vs balloon angioplasty for prevention of recurrences in patients with coronary in-stent restenosis: a randomized controlled trial. JAMA 293:165–171PubMedCrossRef Kastrati A, Mehilli J, von Beckerath N, Dibra A, Hausleiter J, Pache J, Schuhlen H, Schmitt C, Dirschinger J, Schomig A, ISAR-DESIRE Study Investigators (2005) Sirolimus-eluting stent or paclitaxel-eluting stent vs balloon angioplasty for prevention of recurrences in patients with coronary in-stent restenosis: a randomized controlled trial. JAMA 293:165–171PubMedCrossRef
8.
go back to reference Pfisterer M, Brunner-La Rocca HP, Buser PT, Rickenbacher P, Hunziker P, Mueller C, Jeger R, Bader F, Osswald S, Kaiser C, BASKET-LATE Investigators (2006) Late clinical events after clopidogrel discontinuation may limit the benefit of drug-eluting stents: an observational study of drug-eluting versus bare-metal stents. J Am Coll Cardiol 48:2584–2591PubMedCrossRef Pfisterer M, Brunner-La Rocca HP, Buser PT, Rickenbacher P, Hunziker P, Mueller C, Jeger R, Bader F, Osswald S, Kaiser C, BASKET-LATE Investigators (2006) Late clinical events after clopidogrel discontinuation may limit the benefit of drug-eluting stents: an observational study of drug-eluting versus bare-metal stents. J Am Coll Cardiol 48:2584–2591PubMedCrossRef
9.
go back to reference Daemen J, Wenaweser P, Tsuchida K, Abrecht L, Vaina S, Morger C, Kukreja N, Jüni P, Sianos G, Hellige G, van Domburg RT, Hess OM, Boersma E, Meier B, Windecker S, Serruys PW (2007) Early and late coronary stent thrombosis of sirolimus-eluting and paclitaxel-eluting stents in routine clinical practice: data from a large two-institutional cohort study. Lancet 369:667–678PubMedCrossRef Daemen J, Wenaweser P, Tsuchida K, Abrecht L, Vaina S, Morger C, Kukreja N, Jüni P, Sianos G, Hellige G, van Domburg RT, Hess OM, Boersma E, Meier B, Windecker S, Serruys PW (2007) Early and late coronary stent thrombosis of sirolimus-eluting and paclitaxel-eluting stents in routine clinical practice: data from a large two-institutional cohort study. Lancet 369:667–678PubMedCrossRef
10.
go back to reference Waksman R, Pakala R (2009) Drug-eluting balloon: the comeback kid? Circ Cardiovasc Interv 2:352–358PubMedCrossRef Waksman R, Pakala R (2009) Drug-eluting balloon: the comeback kid? Circ Cardiovasc Interv 2:352–358PubMedCrossRef
11.
go back to reference Unverdorben M, Kleber FX, Heuer H, Figulla HR, Vallbracht C, Leschke M, Cremers B, Hardt S, Buerke M, Ackermann H, Boxberger M, Degenhardt R, Scheller B (2010) Treatment of small coronary arteries with a paclitaxel-coated balloon catheter. Clin Res Cardiol 99:165–174PubMedCrossRef Unverdorben M, Kleber FX, Heuer H, Figulla HR, Vallbracht C, Leschke M, Cremers B, Hardt S, Buerke M, Ackermann H, Boxberger M, Degenhardt R, Scheller B (2010) Treatment of small coronary arteries with a paclitaxel-coated balloon catheter. Clin Res Cardiol 99:165–174PubMedCrossRef
12.
go back to reference Scheller B, Hehrlein C, Bocksch W, Rutsch W, Haghi D, Dietz U, Böhm M, Speck U (2006) Treatment of coronary in-stent restenosis with a paclitaxel-coated balloon catheter. N Engl J Med 355:2113–2124PubMedCrossRef Scheller B, Hehrlein C, Bocksch W, Rutsch W, Haghi D, Dietz U, Böhm M, Speck U (2006) Treatment of coronary in-stent restenosis with a paclitaxel-coated balloon catheter. N Engl J Med 355:2113–2124PubMedCrossRef
13.
go back to reference Scheller B, Hehrlein C, Bocksch W, Rutsch W, Haghi D, Dietz U, Böhm M, Speck U (2008) Two year follow-up after treatment of coronary in-stent restenosis with a paclitaxel-coated balloon catheter. Clin Res Cardiol 97:773–781PubMedCrossRef Scheller B, Hehrlein C, Bocksch W, Rutsch W, Haghi D, Dietz U, Böhm M, Speck U (2008) Two year follow-up after treatment of coronary in-stent restenosis with a paclitaxel-coated balloon catheter. Clin Res Cardiol 97:773–781PubMedCrossRef
14.
go back to reference Unverdorben M, Vallbracht C, Cremers B, Heuer H, Hengstenberg C, Maikowski C, Werner GS, Antoni D, Kleber FX, Bocksch W, Leschke M, Ackermann H, Boxberger M, Speck U, Degenhardt R, Scheller B (2009) Paclitaxel-coated balloon catheter versus paclitaxel-coated stent for the treatment of coronary in-stent restenosis. Circulation 119:2986–2994PubMedCrossRef Unverdorben M, Vallbracht C, Cremers B, Heuer H, Hengstenberg C, Maikowski C, Werner GS, Antoni D, Kleber FX, Bocksch W, Leschke M, Ackermann H, Boxberger M, Speck U, Degenhardt R, Scheller B (2009) Paclitaxel-coated balloon catheter versus paclitaxel-coated stent for the treatment of coronary in-stent restenosis. Circulation 119:2986–2994PubMedCrossRef
15.
go back to reference Cremers B, Clever Y, Schaffner S, Speck U, Böhm M, Scheller B (2010) Treatment of coronary in-stent restenosis with a novel paclitaxel urea coated balloon. Minerva Cardioangiol 58:583–588PubMed Cremers B, Clever Y, Schaffner S, Speck U, Böhm M, Scheller B (2010) Treatment of coronary in-stent restenosis with a novel paclitaxel urea coated balloon. Minerva Cardioangiol 58:583–588PubMed
16.
go back to reference Stella PR, Belkacemi A, Waksman R, Stahnke S, Torguson R, von Strandmann RP, Agostoni P, Sangiorgi G, Silber S, Valentine Investigators (2011) The Valentines Trial: results of the first one week worldwide multicentre enrolment trial, evaluating the real world usage of the second generation DIOR paclitaxel drug-eluting balloon for in-stent restenosis treatment. EuroIntervention 7:705–710PubMedCrossRef Stella PR, Belkacemi A, Waksman R, Stahnke S, Torguson R, von Strandmann RP, Agostoni P, Sangiorgi G, Silber S, Valentine Investigators (2011) The Valentines Trial: results of the first one week worldwide multicentre enrolment trial, evaluating the real world usage of the second generation DIOR paclitaxel drug-eluting balloon for in-stent restenosis treatment. EuroIntervention 7:705–710PubMedCrossRef
18.
go back to reference Petrou S, Gray A (2011) Economic evaluation using decision analytical modelling: design, conduct, analysis, and reporting. BMJ 342:d1766PubMedCrossRef Petrou S, Gray A (2011) Economic evaluation using decision analytical modelling: design, conduct, analysis, and reporting. BMJ 342:d1766PubMedCrossRef
19.
go back to reference Stone GW, Mehran R, Dangas G, Lansky AJ, Kornowski R, Leon MB (2001) Differential impact on survival of electrocardiographic Q-wave versus enzymatic myocardial infarction after percutaneous intervention: a device-specific analysis of 7147 patients. Circulation 104:642–647PubMedCrossRef Stone GW, Mehran R, Dangas G, Lansky AJ, Kornowski R, Leon MB (2001) Differential impact on survival of electrocardiographic Q-wave versus enzymatic myocardial infarction after percutaneous intervention: a device-specific analysis of 7147 patients. Circulation 104:642–647PubMedCrossRef
20.
go back to reference Aldea GS, Mokadam NA, Melford R Jr, Stewart D, Maynard C, Reisman M, Goss R (2009) Changing volumes, risk profiles, and outcomes of coronary artery bypass grafting and percutaneous coronary interventions. Ann Thorac Surg 87:1828–1838PubMedCrossRef Aldea GS, Mokadam NA, Melford R Jr, Stewart D, Maynard C, Reisman M, Goss R (2009) Changing volumes, risk profiles, and outcomes of coronary artery bypass grafting and percutaneous coronary interventions. Ann Thorac Surg 87:1828–1838PubMedCrossRef
21.
go back to reference Hoffman SJ, Holmes DR Jr, Rabinstein AA, Rihal CS, Gersh BJ, Lennon RJ, Bashir R, Gulati R (2011) Trends, predictors, and outcomes of cerebrovascular events related to percutaneous coronary intervention: a 16-year single-center experience. JACC Cardiovasc Interv 4:415–422PubMedCrossRef Hoffman SJ, Holmes DR Jr, Rabinstein AA, Rihal CS, Gersh BJ, Lennon RJ, Bashir R, Gulati R (2011) Trends, predictors, and outcomes of cerebrovascular events related to percutaneous coronary intervention: a 16-year single-center experience. JACC Cardiovasc Interv 4:415–422PubMedCrossRef
22.
go back to reference Hannan EL, Racz M, Walford G (2011) Out-of-hospital deaths within 30 days following hospitalization where percutaneous coronary intervention was performed. Am J Cardiol (in press) Hannan EL, Racz M, Walford G (2011) Out-of-hospital deaths within 30 days following hospitalization where percutaneous coronary intervention was performed. Am J Cardiol (in press)
23.
go back to reference Kastrati A, Dibra A, Eberle S, Mehilli J, Suárez de Lezo J, Goy JJ, Ulm K, Schömig A (2005) Sirolimus-eluting stents vs. paclitaxel-eluting stents in patients with coronary artery disease: meta-analysis of randomized trials. JAMA 294:819–825PubMedCrossRef Kastrati A, Dibra A, Eberle S, Mehilli J, Suárez de Lezo J, Goy JJ, Ulm K, Schömig A (2005) Sirolimus-eluting stents vs. paclitaxel-eluting stents in patients with coronary artery disease: meta-analysis of randomized trials. JAMA 294:819–825PubMedCrossRef
24.
go back to reference Tarakji KG, Sabik JF 3rd, Bhudia SK, Batizy LH, Blackstone EH (2011) Temporal onset, risk factors, and outcomes associated with stroke after coronary artery bypass grafting. JAMA 305:381–390PubMedCrossRef Tarakji KG, Sabik JF 3rd, Bhudia SK, Batizy LH, Blackstone EH (2011) Temporal onset, risk factors, and outcomes associated with stroke after coronary artery bypass grafting. JAMA 305:381–390PubMedCrossRef
25.
go back to reference Racz MJ, Hannan EL, Isom OW, Subramanian VA, Jones RH, Gold JP, Ryan TJ, Hartman A, Culliford AT, Bennett E, Lancey RA, Rose EA (2004) A comparison of short- and long-term outcomes after off-pump and on-pump coronary artery bypass graft surgery with sternotomy. J Am Coll Cardiol 43:557–564PubMedCrossRef Racz MJ, Hannan EL, Isom OW, Subramanian VA, Jones RH, Gold JP, Ryan TJ, Hartman A, Culliford AT, Bennett E, Lancey RA, Rose EA (2004) A comparison of short- and long-term outcomes after off-pump and on-pump coronary artery bypass graft surgery with sternotomy. J Am Coll Cardiol 43:557–564PubMedCrossRef
26.
go back to reference Hannan EL, Wu C, Walford G, Culliford AT, Gold JP, Smith CR, Higgins RS, Carlson RE, Jones RH (2008) Drug-eluting stents vs. coronary-artery bypass grafting in multivessel coronary disease. N Engl J Med 358:331–341PubMedCrossRef Hannan EL, Wu C, Walford G, Culliford AT, Gold JP, Smith CR, Higgins RS, Carlson RE, Jones RH (2008) Drug-eluting stents vs. coronary-artery bypass grafting in multivessel coronary disease. N Engl J Med 358:331–341PubMedCrossRef
27.
go back to reference van Domburg RT, Lemos PA, Takkenberg JJ, Liu TK, van Herwerden LA, Arampatzis CA, Smits PC, Daemen J, Venema AC, Serruys PW, Bogers AJ (2005) The impact of the introduction of drug-eluting stents on the clinical practice of surgical and percutaneous treatment of coronary artery disease. Eur Heart J 26:675–681PubMedCrossRef van Domburg RT, Lemos PA, Takkenberg JJ, Liu TK, van Herwerden LA, Arampatzis CA, Smits PC, Daemen J, Venema AC, Serruys PW, Bogers AJ (2005) The impact of the introduction of drug-eluting stents on the clinical practice of surgical and percutaneous treatment of coronary artery disease. Eur Heart J 26:675–681PubMedCrossRef
28.
go back to reference Peters RJ, Mehta SR, Fox KA, Zhao F, Lewis BS, Kopecky SL, Diaz R, Commerford PJ, Valentin V, Yusuf S, Clopidogrel in Unstable angina to prevent Recurrent Events (CURE) Trial Investigators (2003) Effects of aspirin dose when used alone or in combination with clopidogrel in patients with acute coronary syndromes: observations from the Clopidogrel in Unstable angina to prevent Recurrent Events (CURE) study. Circulation 108:1682–1687PubMedCrossRef Peters RJ, Mehta SR, Fox KA, Zhao F, Lewis BS, Kopecky SL, Diaz R, Commerford PJ, Valentin V, Yusuf S, Clopidogrel in Unstable angina to prevent Recurrent Events (CURE) Trial Investigators (2003) Effects of aspirin dose when used alone or in combination with clopidogrel in patients with acute coronary syndromes: observations from the Clopidogrel in Unstable angina to prevent Recurrent Events (CURE) study. Circulation 108:1682–1687PubMedCrossRef
29.
go back to reference Hansen ML, Sørensen R, Clausen MT, Fog-Petersen ML, Raunsø J, Gadsbøll N, Gislason GH, Folke F, Andersen SS, Schramm TK, Abildstrøm SZ, Poulsen HE, Køber L, Torp-Pedersen C (2010) Risk of bleeding with single, dual, or triple therapy with warfarin, aspirin, and clopidogrel in patients with atrial fibrillation. Arch Intern Med 170:1433–1441PubMedCrossRef Hansen ML, Sørensen R, Clausen MT, Fog-Petersen ML, Raunsø J, Gadsbøll N, Gislason GH, Folke F, Andersen SS, Schramm TK, Abildstrøm SZ, Poulsen HE, Køber L, Torp-Pedersen C (2010) Risk of bleeding with single, dual, or triple therapy with warfarin, aspirin, and clopidogrel in patients with atrial fibrillation. Arch Intern Med 170:1433–1441PubMedCrossRef
30.
go back to reference Setoguchi S, Glynn RJ, Avorn J, Mittleman MA, Levin R, Winkelmayer WC (2008) Improvements in long-term mortality after myocardial infarction and increased use of cardiovascular drugs after discharge: a 10-year trend analysis. J Am Coll Cardiol 51:1247–1254PubMedCrossRef Setoguchi S, Glynn RJ, Avorn J, Mittleman MA, Levin R, Winkelmayer WC (2008) Improvements in long-term mortality after myocardial infarction and increased use of cardiovascular drugs after discharge: a 10-year trend analysis. J Am Coll Cardiol 51:1247–1254PubMedCrossRef
31.
go back to reference Scheller B (2011) Opportunities and limitations of drug-coated balloons in interventional therapies. Herz 36:232–239PubMedCrossRef Scheller B (2011) Opportunities and limitations of drug-coated balloons in interventional therapies. Herz 36:232–239PubMedCrossRef
33.
go back to reference Henschke C, Baeumler M, Gaskins M, Busse R (2010) Coronary stents and the uptake of new medical devices in the German system of inpatient reimbursement. J Interven Cardiol 23:546–553CrossRef Henschke C, Baeumler M, Gaskins M, Busse R (2010) Coronary stents and the uptake of new medical devices in the German system of inpatient reimbursement. J Interven Cardiol 23:546–553CrossRef
34.
go back to reference Rote Liste Service GmbH (2010) Rote Liste 2010. Arzneimittelinformationen für Deutschland. Rote Liste Service GmbH, Frankfurt am Main, Germany Rote Liste Service GmbH (2010) Rote Liste 2010. Arzneimittelinformationen für Deutschland. Rote Liste Service GmbH, Frankfurt am Main, Germany
35.
go back to reference Soskuty G (2010) Innovationen in Diagnostik und Therapie: Zugang und Hürden im System. In: Rebscher H, Kaufmann S (eds) Innovationsmanagement in Gesundheitssystemen. Medhochzwei, Heidelberg, pp 159–174 Soskuty G (2010) Innovationen in Diagnostik und Therapie: Zugang und Hürden im System. In: Rebscher H, Kaufmann S (eds) Innovationsmanagement in Gesundheitssystemen. Medhochzwei, Heidelberg, pp 159–174
36.
go back to reference Schweikert B, Hahmann H, Steinacker JM, Imhof A, Muche R, Koenig W, Liu Y, Leidl R (2009) Intervention study shows outpatient cardiac rehabilitation to be economically at least as attractive as inpatient rehabilitation. Clin Res Cardiol 98:787–795PubMedCrossRef Schweikert B, Hahmann H, Steinacker JM, Imhof A, Muche R, Koenig W, Liu Y, Leidl R (2009) Intervention study shows outpatient cardiac rehabilitation to be economically at least as attractive as inpatient rehabilitation. Clin Res Cardiol 98:787–795PubMedCrossRef
37.
go back to reference Kolominsky-Rabas PL, Heuschmann PU, Marschall D, Emmert M, Baltzer N, Neundörfer B, Schöffski O, Krobot KJ (2006) Lifetime cost of ischemic stroke in Germany: results and national projections from a population-based stroke registry: the Erlangen Stroke Project. Stroke 37:1179–1183PubMedCrossRef Kolominsky-Rabas PL, Heuschmann PU, Marschall D, Emmert M, Baltzer N, Neundörfer B, Schöffski O, Krobot KJ (2006) Lifetime cost of ischemic stroke in Germany: results and national projections from a population-based stroke registry: the Erlangen Stroke Project. Stroke 37:1179–1183PubMedCrossRef
38.
go back to reference Bonaventura K, Sonntag S, Kleber FX (2011) Antiplatelet therapy in the era of percutaneous coronary intervention with drug-eluting balloons. EuroIntervention 7:K106–K111PubMedCrossRef Bonaventura K, Sonntag S, Kleber FX (2011) Antiplatelet therapy in the era of percutaneous coronary intervention with drug-eluting balloons. EuroIntervention 7:K106–K111PubMedCrossRef
39.
go back to reference Kleber FX, Mathey DG, Rittger H, Scheller B (2011) On behalf of the German drug-eluting balloon consensus group. How to use the drug-eluting balloon. Recommendations by the German consensus group. EuroIntervention 7:K125–K128PubMedCrossRef Kleber FX, Mathey DG, Rittger H, Scheller B (2011) On behalf of the German drug-eluting balloon consensus group. How to use the drug-eluting balloon. Recommendations by the German consensus group. EuroIntervention 7:K125–K128PubMedCrossRef
40.
go back to reference Scheller B, Levenson B, Joner M, Zahn R, Klauss V, Naber C, Schächinger V, Elsässer A, Arbeitsgruppe Interventionelle Kardiologie (AGIK) der Deutschen Gesellschaft für Kardiologie (DGK) (2011) Drug-eluting coronary stents and drug-coated balloon catheters. 2011 Position Paper of the German Cardiac Society. Kardiologe 5:411–435CrossRef Scheller B, Levenson B, Joner M, Zahn R, Klauss V, Naber C, Schächinger V, Elsässer A, Arbeitsgruppe Interventionelle Kardiologie (AGIK) der Deutschen Gesellschaft für Kardiologie (DGK) (2011) Drug-eluting coronary stents and drug-coated balloon catheters. 2011 Position Paper of the German Cardiac Society. Kardiologe 5:411–435CrossRef
41.
go back to reference Mongan JJ, Ferris TG, Lee TH (2008) Options for slowing the growth of health care costs. N Engl J Med 358:1509–1514PubMedCrossRef Mongan JJ, Ferris TG, Lee TH (2008) Options for slowing the growth of health care costs. N Engl J Med 358:1509–1514PubMedCrossRef
42.
go back to reference Bodenheimer T (2005) High and rising health care costs. Part 2: technologic innovation. Ann Intern Med 142:932–937PubMed Bodenheimer T (2005) High and rising health care costs. Part 2: technologic innovation. Ann Intern Med 142:932–937PubMed
43.
go back to reference Cohen DJ, Reynolds MR (2008) Interpreting the results of cost-effectiveness studies. J Am Coll Cardiol 52:2119–2126PubMedCrossRef Cohen DJ, Reynolds MR (2008) Interpreting the results of cost-effectiveness studies. J Am Coll Cardiol 52:2119–2126PubMedCrossRef
44.
go back to reference Glick HA, Doshi JA, Sonnad SS, Polsky D (2007) Sampling uncertainty: calculation, sample size and power, and decision criteria. In: Glick HA, Doshi JA, Sonnad SS, Polsky D (eds) Economic evaluation in clinical trials. Oxford University Press, Oxford, pp 179–206 Glick HA, Doshi JA, Sonnad SS, Polsky D (2007) Sampling uncertainty: calculation, sample size and power, and decision criteria. In: Glick HA, Doshi JA, Sonnad SS, Polsky D (eds) Economic evaluation in clinical trials. Oxford University Press, Oxford, pp 179–206
45.
go back to reference Bilcke J, Beutels P, Brisson M, Jit M (2011) Accounting for methodological, structural, and parameter uncertainty in decision-analytic models: a practical guide. Med Decis Making 31:675–692PubMedCrossRef Bilcke J, Beutels P, Brisson M, Jit M (2011) Accounting for methodological, structural, and parameter uncertainty in decision-analytic models: a practical guide. Med Decis Making 31:675–692PubMedCrossRef
46.
go back to reference Hamm CW, Bassand JP, Agewall S, Bax J, Boersma E, Bueno H, Caso P, Dudek D, Gielen S, Huber K, Ohman M, Petrie MC, Sonntag F, Uva MS, Storey RF, Wijns W, Zahger D, ESC Committee for Practice Guidelines, Bax JJ, Auricchio A, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Knuuti J, Kolh P, McDonagh T, Moulin C, Poldermans D, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Torbicki A, Vahanian A, Windecker S, Document Reviewers, Windecker S, Achenbach S, Badimon L, Bertrand M, Bøtker HE, Collet JP, Crea F, Danchin N, Falk E, Goudevenos J, Gulba D, Hambrecht R, Herrmann J, Kastrati A, Kjeldsen K, Kristensen SD, Lancellotti P, Mehilli J, Merkely B, Montalescot G, Neumann FJ, Neyses L, Perk J, Roffi M, Romeo F, Ruda M, Swahn E, Valgimigli M, Vrints CJ, Widimsky P (2011) ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the Management of Acute Coronary Syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J (in press) Hamm CW, Bassand JP, Agewall S, Bax J, Boersma E, Bueno H, Caso P, Dudek D, Gielen S, Huber K, Ohman M, Petrie MC, Sonntag F, Uva MS, Storey RF, Wijns W, Zahger D, ESC Committee for Practice Guidelines, Bax JJ, Auricchio A, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Knuuti J, Kolh P, McDonagh T, Moulin C, Poldermans D, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Torbicki A, Vahanian A, Windecker S, Document Reviewers, Windecker S, Achenbach S, Badimon L, Bertrand M, Bøtker HE, Collet JP, Crea F, Danchin N, Falk E, Goudevenos J, Gulba D, Hambrecht R, Herrmann J, Kastrati A, Kjeldsen K, Kristensen SD, Lancellotti P, Mehilli J, Merkely B, Montalescot G, Neumann FJ, Neyses L, Perk J, Roffi M, Romeo F, Ruda M, Swahn E, Valgimigli M, Vrints CJ, Widimsky P (2011) ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the Management of Acute Coronary Syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J (in press)
47.
go back to reference Neubauer H, Krüger JC, Lask S, Endres HG, Pepinghege F, Engelhardt A, Bulut D, Mügge A (2009) Comparing the antiplatelet effect of clopidogrel hydrogensulfate and clopidogrel besylate: a crossover study. Clin Res Cardiol 98:533–540PubMedCrossRef Neubauer H, Krüger JC, Lask S, Endres HG, Pepinghege F, Engelhardt A, Bulut D, Mügge A (2009) Comparing the antiplatelet effect of clopidogrel hydrogensulfate and clopidogrel besylate: a crossover study. Clin Res Cardiol 98:533–540PubMedCrossRef
48.
go back to reference Silber S, Borggrefe M, Böhm M, Hoffmeister HM, Dietz R, Ertl G, Heusch G (2008) Drug-eluting coronary stents and drug eluting balloon catheters: summary of the position papers of the DGK. Clin Res Cardiol 97:548–563PubMedCrossRef Silber S, Borggrefe M, Böhm M, Hoffmeister HM, Dietz R, Ertl G, Heusch G (2008) Drug-eluting coronary stents and drug eluting balloon catheters: summary of the position papers of the DGK. Clin Res Cardiol 97:548–563PubMedCrossRef
49.
go back to reference Weber FD, Schneider H, Wiemer M, Pfannebecker T, Tebbe U, Hamm CW, Senges J, Schneider S, Nienaber CA (2008) Sirolimus eluting stent (Cypher) in patients with diabetes mellitus: results from the German Cypher Stent Registry. Clin Res Cardiol 97:105–109PubMedCrossRef Weber FD, Schneider H, Wiemer M, Pfannebecker T, Tebbe U, Hamm CW, Senges J, Schneider S, Nienaber CA (2008) Sirolimus eluting stent (Cypher) in patients with diabetes mellitus: results from the German Cypher Stent Registry. Clin Res Cardiol 97:105–109PubMedCrossRef
50.
go back to reference Möllmann H, Elsässer A, Nef H, Schneider S, Nienaber CA, Richardt G, Weber M, Kelm M, Levenson B, Bonzel T, Tebbe U, Sabin G, Pfannebecker T, Senges J, Hamm CW (2008) Treatment of in-stent restenosis with sirolimus-eluting-stents: results from the prospective German Cypher stent registry. Clin Res Cardiol 97:432–440PubMedCrossRef Möllmann H, Elsässer A, Nef H, Schneider S, Nienaber CA, Richardt G, Weber M, Kelm M, Levenson B, Bonzel T, Tebbe U, Sabin G, Pfannebecker T, Senges J, Hamm CW (2008) Treatment of in-stent restenosis with sirolimus-eluting-stents: results from the prospective German Cypher stent registry. Clin Res Cardiol 97:432–440PubMedCrossRef
51.
go back to reference Siller-Matula JM, Tentzeris I, Vogel B, Schacherl S, Jarai R, Geppert A, Unger G, Huber K (2010) Tacrolimus-eluting carbon-coated stents versus sirolimus-eluting stents for prevention of symptom-driven clinical end points. Clin Res Cardiol 99:645–650PubMedCrossRef Siller-Matula JM, Tentzeris I, Vogel B, Schacherl S, Jarai R, Geppert A, Unger G, Huber K (2010) Tacrolimus-eluting carbon-coated stents versus sirolimus-eluting stents for prevention of symptom-driven clinical end points. Clin Res Cardiol 99:645–650PubMedCrossRef
52.
go back to reference Akin I, Bufe A, Schneider S, Reinecke H, Eckardt L, Richardt G, Burska D, Senges J, Kuck KH, Nienaber CA (2010) Clinical outcomes in diabetic and non-diabetic patients with drug-eluting stents: results from the first phase of the prospective multicenter German DES.DE registry. Clin Res Cardiol 99:393–400PubMedCrossRef Akin I, Bufe A, Schneider S, Reinecke H, Eckardt L, Richardt G, Burska D, Senges J, Kuck KH, Nienaber CA (2010) Clinical outcomes in diabetic and non-diabetic patients with drug-eluting stents: results from the first phase of the prospective multicenter German DES.DE registry. Clin Res Cardiol 99:393–400PubMedCrossRef
Metadata
Title
Cost-effectiveness of paclitaxel-coated balloon angioplasty and paclitaxel-eluting stent implantation for treatment of coronary in-stent restenosis in patients with stable coronary artery disease
Authors
Klaus Bonaventura
Alexander W. Leber
Christian Sohns
Mattias Roser
Leif-Hendrik Boldt
Franz X. Kleber
Wilhelm Haverkamp
Marc Dorenkamp
Publication date
01-07-2012
Publisher
Springer-Verlag
Published in
Clinical Research in Cardiology / Issue 7/2012
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI
https://doi.org/10.1007/s00392-012-0428-2

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