Economic modeling of new stent platforms to evaluate cost effectiveness

Analysis of the TAXUS Liberté versus TAXUS express stents

Mark A. Turco, Anuraag R. Kansal, Sean Stern, Stacey L. Amorosi, Paul L. Underwood, Greg De Lissovoy, Keith D. Dawkins

Research output: Contribution to journalArticle

Abstract

Background: With the changing health care environment, cost effectiveness is an important adjunct to clinical investigation when assessing new medical devices. This study presents an economic model to evaluate cost effectiveness of coronary stents. Methods: Markov modeling was developed comparing total costs (Medicare payer perspective) between TAXUS Liberté and TAXUS Express based on 3-year clinical outcomes from the TAXUS ATLAS Small Vessel and Long Lesion trials. Results: The TAXUS Liberté 2.25-mm stent provided cost savings relative to TAXUS Express from a payer perspective ($17,605 vs. $20,281), driven by reduced target vessel revascularization (0.16 events/patient vs. 0.33 events/patient). In probabilistic sensitivity analyses, TAXUS Liberté was less costly with fewer major adverse cardiac events in over 99% of parameter sets. The TAXUS Liberté Long (38 mm) stent was cost neutral relative to TAXUS Express from a payer perspective ($18,545 vs. $18,551) with fewer myocardial infarctions and cardiac deaths. Accounting for angiography-driven revascularizations, TAXUS Liberté 2.25 mm still provided cost savings relative to TAXUS Express ($16,822 vs. $19,139), although TAXUS Liberté Long was more expensive than TAXUS Express ($17,886 vs. $17,652). From a hospital perspective, TAXUS Liberté Long provided cost savings up to a price premium of $671/stent, driven by fewer stents employed per patient. Conclusions: This analysis confirms the utility of economic modeling in assessing new stent platforms. TAXUS Liberté 2.25 mm is economically dominant relative to TAXUS Express when treating small vessels. TAXUS Liberté Long is cost neutral to modestly more costly than TAXUS Express 2.25 mm from a payer perspective. (J Interven Cardiol 2012;25:353-363)

Original languageEnglish (US)
Pages (from-to)353-363
Number of pages11
JournalJournal of Interventional Cardiology
Volume25
Issue number4
DOIs
StatePublished - Aug 2012
Externally publishedYes

Fingerprint

Cost-Benefit Analysis
Stents
Economics
Cost Savings
Costs and Cost Analysis
Economic Models
Medicare
Health Care Costs
Angiography
Myocardial Infarction
Equipment and Supplies

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Economic modeling of new stent platforms to evaluate cost effectiveness : Analysis of the TAXUS Liberté versus TAXUS express stents. / Turco, Mark A.; Kansal, Anuraag R.; Stern, Sean; Amorosi, Stacey L.; Underwood, Paul L.; Lissovoy, Greg De; Dawkins, Keith D.

In: Journal of Interventional Cardiology, Vol. 25, No. 4, 08.2012, p. 353-363.

Research output: Contribution to journalArticle

Turco, Mark A. ; Kansal, Anuraag R. ; Stern, Sean ; Amorosi, Stacey L. ; Underwood, Paul L. ; Lissovoy, Greg De ; Dawkins, Keith D. / Economic modeling of new stent platforms to evaluate cost effectiveness : Analysis of the TAXUS Liberté versus TAXUS express stents. In: Journal of Interventional Cardiology. 2012 ; Vol. 25, No. 4. pp. 353-363.
@article{48e8674e8bf345b383b8557ef5a6baa2,
title = "Economic modeling of new stent platforms to evaluate cost effectiveness: Analysis of the TAXUS Libert{\'e} versus TAXUS express stents",
abstract = "Background: With the changing health care environment, cost effectiveness is an important adjunct to clinical investigation when assessing new medical devices. This study presents an economic model to evaluate cost effectiveness of coronary stents. Methods: Markov modeling was developed comparing total costs (Medicare payer perspective) between TAXUS Libert{\'e} and TAXUS Express based on 3-year clinical outcomes from the TAXUS ATLAS Small Vessel and Long Lesion trials. Results: The TAXUS Libert{\'e} 2.25-mm stent provided cost savings relative to TAXUS Express from a payer perspective ($17,605 vs. $20,281), driven by reduced target vessel revascularization (0.16 events/patient vs. 0.33 events/patient). In probabilistic sensitivity analyses, TAXUS Libert{\'e} was less costly with fewer major adverse cardiac events in over 99{\%} of parameter sets. The TAXUS Libert{\'e} Long (38 mm) stent was cost neutral relative to TAXUS Express from a payer perspective ($18,545 vs. $18,551) with fewer myocardial infarctions and cardiac deaths. Accounting for angiography-driven revascularizations, TAXUS Libert{\'e} 2.25 mm still provided cost savings relative to TAXUS Express ($16,822 vs. $19,139), although TAXUS Libert{\'e} Long was more expensive than TAXUS Express ($17,886 vs. $17,652). From a hospital perspective, TAXUS Libert{\'e} Long provided cost savings up to a price premium of $671/stent, driven by fewer stents employed per patient. Conclusions: This analysis confirms the utility of economic modeling in assessing new stent platforms. TAXUS Libert{\'e} 2.25 mm is economically dominant relative to TAXUS Express when treating small vessels. TAXUS Libert{\'e} Long is cost neutral to modestly more costly than TAXUS Express 2.25 mm from a payer perspective. (J Interven Cardiol 2012;25:353-363)",
author = "Turco, {Mark A.} and Kansal, {Anuraag R.} and Sean Stern and Amorosi, {Stacey L.} and Underwood, {Paul L.} and Lissovoy, {Greg De} and Dawkins, {Keith D.}",
year = "2012",
month = "8",
doi = "10.1111/j.1540-8183.2012.00737.x",
language = "English (US)",
volume = "25",
pages = "353--363",
journal = "Journal of Interventional Cardiology",
issn = "0896-4327",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - Economic modeling of new stent platforms to evaluate cost effectiveness

T2 - Analysis of the TAXUS Liberté versus TAXUS express stents

AU - Turco, Mark A.

AU - Kansal, Anuraag R.

AU - Stern, Sean

AU - Amorosi, Stacey L.

AU - Underwood, Paul L.

AU - Lissovoy, Greg De

AU - Dawkins, Keith D.

PY - 2012/8

Y1 - 2012/8

N2 - Background: With the changing health care environment, cost effectiveness is an important adjunct to clinical investigation when assessing new medical devices. This study presents an economic model to evaluate cost effectiveness of coronary stents. Methods: Markov modeling was developed comparing total costs (Medicare payer perspective) between TAXUS Liberté and TAXUS Express based on 3-year clinical outcomes from the TAXUS ATLAS Small Vessel and Long Lesion trials. Results: The TAXUS Liberté 2.25-mm stent provided cost savings relative to TAXUS Express from a payer perspective ($17,605 vs. $20,281), driven by reduced target vessel revascularization (0.16 events/patient vs. 0.33 events/patient). In probabilistic sensitivity analyses, TAXUS Liberté was less costly with fewer major adverse cardiac events in over 99% of parameter sets. The TAXUS Liberté Long (38 mm) stent was cost neutral relative to TAXUS Express from a payer perspective ($18,545 vs. $18,551) with fewer myocardial infarctions and cardiac deaths. Accounting for angiography-driven revascularizations, TAXUS Liberté 2.25 mm still provided cost savings relative to TAXUS Express ($16,822 vs. $19,139), although TAXUS Liberté Long was more expensive than TAXUS Express ($17,886 vs. $17,652). From a hospital perspective, TAXUS Liberté Long provided cost savings up to a price premium of $671/stent, driven by fewer stents employed per patient. Conclusions: This analysis confirms the utility of economic modeling in assessing new stent platforms. TAXUS Liberté 2.25 mm is economically dominant relative to TAXUS Express when treating small vessels. TAXUS Liberté Long is cost neutral to modestly more costly than TAXUS Express 2.25 mm from a payer perspective. (J Interven Cardiol 2012;25:353-363)

AB - Background: With the changing health care environment, cost effectiveness is an important adjunct to clinical investigation when assessing new medical devices. This study presents an economic model to evaluate cost effectiveness of coronary stents. Methods: Markov modeling was developed comparing total costs (Medicare payer perspective) between TAXUS Liberté and TAXUS Express based on 3-year clinical outcomes from the TAXUS ATLAS Small Vessel and Long Lesion trials. Results: The TAXUS Liberté 2.25-mm stent provided cost savings relative to TAXUS Express from a payer perspective ($17,605 vs. $20,281), driven by reduced target vessel revascularization (0.16 events/patient vs. 0.33 events/patient). In probabilistic sensitivity analyses, TAXUS Liberté was less costly with fewer major adverse cardiac events in over 99% of parameter sets. The TAXUS Liberté Long (38 mm) stent was cost neutral relative to TAXUS Express from a payer perspective ($18,545 vs. $18,551) with fewer myocardial infarctions and cardiac deaths. Accounting for angiography-driven revascularizations, TAXUS Liberté 2.25 mm still provided cost savings relative to TAXUS Express ($16,822 vs. $19,139), although TAXUS Liberté Long was more expensive than TAXUS Express ($17,886 vs. $17,652). From a hospital perspective, TAXUS Liberté Long provided cost savings up to a price premium of $671/stent, driven by fewer stents employed per patient. Conclusions: This analysis confirms the utility of economic modeling in assessing new stent platforms. TAXUS Liberté 2.25 mm is economically dominant relative to TAXUS Express when treating small vessels. TAXUS Liberté Long is cost neutral to modestly more costly than TAXUS Express 2.25 mm from a payer perspective. (J Interven Cardiol 2012;25:353-363)

UR - http://www.scopus.com/inward/record.url?scp=84864593978&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84864593978&partnerID=8YFLogxK

U2 - 10.1111/j.1540-8183.2012.00737.x

DO - 10.1111/j.1540-8183.2012.00737.x

M3 - Article

VL - 25

SP - 353

EP - 363

JO - Journal of Interventional Cardiology

JF - Journal of Interventional Cardiology

SN - 0896-4327

IS - 4

ER -