Abstract
Objectives of study: Calculating the direct and indirect costs of using coated coronary stents (DES = drug eluting stents) compared with uncoated stents (BMS = bare metal stents) in interventional cardiology, and computation of the anticipated overall costs in Switzerland. Method: Model-based cost computation on the basis of clinical meta-analyses, register analyses, epidemiological and Swiss cost data. The perspective was that of the statutory sickfunds. Result: Implantation of DES instead of the BMS used hitherto results, in view of the high procurement costs, in an additional average expenditure per patient of CHF 1673. The additional costs occasioned by revascularisation measures for restenosis are, however, reduced by an average of CHF 2419 per patient by DES implantation instead of BMS implantation. Thus, overall and in all the patient groups studied, DES implantation is a cost-saving factor in Switzerland since the savings from averted revascularisation measures exceed the higher procurement costs of DES. The average saving is CHF 745 per patient. Through the additional replacement of bypass surgery, DES implantation allows further cost savings. The latter are realised more rapidly since implantation of DES in place of the BMS can be performed on a routine basis. Conclusion: Implantation of DES instead of BMS is a net cost-saving intervention in the Swiss health care system.