A paper published today in the Scandinavian Cardiovascular Journal highlights that the TAXUS™ drug-eluting stent (DES) system is cost-effective compared to bare metal stents (BMS) in high-risk patients with coronary artery disease (CAD) treated in Sweden.1 For high-risk patients, when compared to BMS, the TAXUS stent system is cost-effective at 12 months and could lead to significant savings at 24 months despite the higher initial cost of the device. The authors also argue that if a cost-effectiveness measure of cost per revascularization avoided is used, the TAXUS stent system is cost-effective in average-risk patients at 12- and 24-months.

In Sweden, 10 percent of the adult population suffers from cardiovascular conditions, which account for half of all deaths.2 The Swedish healthcare system currently spends SEK 1,820 million (? 200 million) each year on cardiovascular interventions.6 Much of this cost is spent on repeat revascularization procedures due to reclogging of arteries, an outcome that is significantly reduced with the TAXUS stent system.3,4

Dr Iwar Sj?gren of Falu Lasarett hospital, Department of Cardiology, Sweden, and co-author of the study said, "Introduction of new technology is frequently viewed with caution due the higher initial cost. However, our study clearly shows that after only 12 months, the TAXUS stent system is cost-effective compared to BMS in high-risk patients. The higher initial costs are compensated by the steep reduction in repeat procedures. In addition to savings, the TAXUS stent system also leads to improved quality of life for the patients concerned."

The study focused on cost savings due to avoidance of repeat procedures. For a patient at average risk, repeat procedures following BMS over 24-months cost SEK 14,579 (? 1,597) per patient compared to only SEK 4,167 (? 457) following treatment with the TAXUS stent system.1

-- For patients at average risk, the 24-month target lesion revascularization (TLR) rate is 17.4 percent for BMS, and 5.6 percent for the TAXUS DES3,4 -- For high-risk patients, 24-month TLR rates are 23.3 percent for BMS and 7.7 percent for the TAXUS DES3,4

Although the study is based on 24-month data that was available at the time, recently presented three- and four-year clinical data also suggest the cost-effectiveness of the TAXUS stent system in the long-term.5

In 2004, 48,500 Swedish people were hospitalized for ischemic heart disease and approximately 20,000 underwent either coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI; i.e. stenting).6 Approximately 75 percent of patients undergo PCI, of whom 50 percent are currently treated with DES. 6

Based on an analysis of initial 12-month costs, the study suggests that use of the TAXUS stent system in 80 percent of high-risk patients undergoing PCI would not significantly increase the budget of the Swedish healthcare system (+0.8 percent). In fact, savings per avoided revascularization procedure in the general Swedish population at 12 months with the TAXUS stent system are SEK 46,801 (? 5,126), which is considered cost-effective.7 Studies in other European countries also found the TAXUS stent system to be cost-effective.8,9

Furthermore, switching patients from CABG to the TAXUS DES could also lead to significant savings. If 80 percent of all PCI patients plus 95 percent of CABG patients were to be treated with DES, budget savings could be significant (12 percent reduction based on the assumptions used by the authors).1 Ongoing studies such as the SYNTAX trial, which evaluates treatment of complex patients with DES versus CABG, will help determine the most cost-effective and best standard care treatment strategy for patients.

TAXUS is the worldwide market leader in drug-eluting stents used to treat CAD. Upon placement of the TAXUS stent to prop open a clogged coronary artery, the drug paclitaxel is released over a period of time to prevent, or inhibit, the build up of new plaque around the treated lesion which can lead to restenosis (reclogging) of the heart vessel.

Boston Scientific is a worldwide developer, manufacturer and marketer of medical devices whose products are used in a broad range of interventional medical specialties. For more information, please visit: bostonscientific.

References:
1 Ekman M, Sj?gren I, James S. Scand Cardiovasc J. 2006;40(1):17-24..
2 Swedish National Board of Health and Welfare socialstyrelsen.se/NR/rdonlyres/3F57E663-B6A9-48CF-AC1C-38B7BD594638/4601/2005428.pdf
3 Stone GW. Presented at the TCT symposium 2004; URL: tctmd/expert-presentations/multi-slide.html?product_id_/7775.
4 Moussa I. Presented at the TCT symposium 2004; URL: tctmd/expert-presentations/slide.html?type_id_/2822.
5 Stone G. presented at the TCT symposium 2005; tctmd/csportal/ShowBinary/BEA%20Repository/TCTMD%20Portal/EPSlidePresPoolNew/2005/Slides_Nov05/Stone_T05_M0840//pdfFile
6 SCAAR Annual Report 2004. Swedish Coronary Angiography and Angioplasty Registry. Uppsala Clinical Research Center, Uppsala University 2005 [In Swedish].
7 Cohen DJ, Bakhai A, Shi C, Githiora L, et al. Circulation. 2004;/110:/508_/14.
8 Fricke F-U, Silber S, Herz. (2005), 30: pp. 332-8.
9 Sangiorgi G, et al. Heart. J. Suppl (2005), 6: pp. 145-56.

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