Background
New stent technologies and expanded stent matrices may impact healthcare costs for payers and providers. We evaluated the cost-effectiveness of TAXUS Liberté Long drug-eluting stents (DES) vs. TAXUS Express DES in patients with long lesions (LL, ≥26–≤34 mm) from payer and hospital perspectives using an economic model.
Methods
A Markov model was developed comparing total costs between TAXUS Liberté and TAXUS Express over 3 years based on TAXUS ATLAS LL trial clinical outcomes. Costs were evaluated from a Medicare payer perspective. Scenario analysis was performed from a hospital perspective to account for stent cost using Millennium Research Group pricing data.
Methods
A Markov model was developed comparing total costs between TAXUS Liberté and TAXUS Express over 3 years based on TAXUS ATLAS LL trial clinical outcomes. Costs were evaluated from a Medicare payer perspective. Scenario analysis was performed from a hospital perspective to account for stent cost using Millennium Research Group pricing data.
Results
TAXUS Liberté was cost neutral over 3 years relative to TAXUS Express from a payer perspective ($18,545 vs. $18,551). Cost savings of lower myocardial infarction and cardiac death rates with TAXUS Liberté vs. TAXUS Express (0.05 vs. 0.18 event/patient) were offset in the model by incremental costs of a higher coronary artery bypass grafting rate with TAXUS Liberté (0.05 vs. 0.01 event/patient). Probabilistic sensitivity analyses, varying clinical parameters to create statistically plausible sets, show that TAXUS Liberté is economically dominant (less costly with fewer major adverse cardiac events, MACE) in 52% of these sets, and a further 34% have acceptable cost–benefit tradeoff (<$10,000 per MACE avoided). From a hospital perspective, TAXUS Liberté vs. TAXUS Express provided cost savings up to a price premium of $671/stent, as driven by fewer stents used per patient.
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