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http://hdl.handle.net/2445/130500
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DC Field | Value | Language |
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dc.contributor.author | Schur, Nadine | - |
dc.contributor.author | Brugaletta, Salvatore | - |
dc.contributor.author | Cequier Fillat, Àngel R. | - |
dc.contributor.author | Iñiguez Romo, Andres | - |
dc.contributor.author | Serra, Antonio | - |
dc.contributor.author | Jiménez Quevedo, Pilar | - |
dc.contributor.author | Mainar, Vicente | - |
dc.contributor.author | Campo, Gianluca | - |
dc.contributor.author | Tespili, Maurizio | - |
dc.contributor.author | Heijer, Peter den | - |
dc.contributor.author | Bethencourt, Armando | - |
dc.contributor.author | Vazquez, Nicolás | - |
dc.contributor.author | Valgimigli, Marco | - |
dc.contributor.author | Serruys, Patrick W. | - |
dc.contributor.author | Ademi, Zanfina | - |
dc.contributor.author | Schwenkglenks, Matthias | - |
dc.contributor.author | Sabaté Tenas, Manuel | - |
dc.date.accessioned | 2019-03-18T12:04:44Z | - |
dc.date.available | 2019-03-18T12:04:44Z | - |
dc.date.issued | 2018-08-16 | - |
dc.identifier.issn | 1932-6203 | - |
dc.identifier.uri | http://hdl.handle.net/2445/130500 | - |
dc.description.abstract | BACKGROUND: Use of everolimus-eluting stents (EES) has proven to be clinically effective and safe in patients with ST-segment elevation myocardial infarction but it remains unclear whether it is cost-effective compared to bare-metal stents (BMS) in the long-term. We sought to assess the cost-effectiveness of EES versus BMS based on the 5-year results of the EXAMINATION trial, from a Spanish health service perspective. METHODS: Decision analysis of the use of EES versus BMS was based on the patient-level clinical outcome data of the EXAMINATION trial. The analysis adopted a lifelong time horizon, assuming that long-term survival was independent of the initial treatment strategy after the end of follow-up. Life-expectancy, health-state utility scores and unit costs were extracted from published literature and publicly available sources. Non-parametric bootstrapping was combined with probabilistic sensitivity analysis to co-assess the impact of patient-level variation and parameter uncertainty. The main outcomes were total costs and quality-adjusted life-years. The incremental cost-effectiveness ratio was expressed as cost per quality-adjusted life-years gained. Costs and effects were discounted at 3%. RESULTS: The model predicted an average survival time in patients receiving EES and BMS of 10.52 and 10.38 undiscounted years, respectively. Over the life-long time horizon, the EES strategy was ¿430 more costly than BMS (¿8,305 vs. ¿7,874), but went along with incremental gains of 0.10 quality-adjusted life-years. This resulted in an average incremental cost-effectiveness ratio over all simulations of ¿3,948 per quality-adjusted life-years gained and was below a willingness-to-pay threshold of ¿25,000 per quality-adjusted life-years gained in 86.9% of simulation runs. CONCLUSIONS: Despite higher total costs relative to BMS, EES appeared to be a cost-effective therapy for ST-segment elevation myocardial infarction patients due to their incremental effectiveness. Predicted incremental cost-effectiveness ratios were below generally acceptable threshold values. | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | eng | - |
dc.publisher | Public Library of Science (PLoS) | - |
dc.relation.isformatof | Reproducció del document publicat a: https://doi.org/10.1371/journal.pone.0201985 | - |
dc.relation.ispartof | PLoS One, 2018, vol. 13, num. 8, p. e0201985 | - |
dc.relation.uri | https://doi.org/10.1371/journal.pone.0201985 | - |
dc.rights | cc-by (c) Schur, Nadine et al., 2018 | - |
dc.rights.uri | http://creativecommons.org/licenses/by/3.0/es | - |
dc.source | Articles publicats en revistes (Ciències Clíniques) | - |
dc.subject.classification | Infart de miocardi | - |
dc.subject.classification | Anàlisi cost-benefici | - |
dc.subject.classification | Terapèutica | - |
dc.subject.classification | Espanya | - |
dc.subject.other | Myocardial infarction | - |
dc.subject.other | Cost effectiveness | - |
dc.subject.other | Therapeutics | - |
dc.subject.other | Spain | - |
dc.title | Cost-effectiveness of everolimus-eluting versus bare-metal stents in ST-segment elevation myocardial infarction: An analysis from the EXAMINATION randomized controlled trial. | - |
dc.type | info:eu-repo/semantics/article | - |
dc.type | info:eu-repo/semantics/publishedVersion | - |
dc.identifier.idgrec | 684629 | - |
dc.date.updated | 2019-03-18T12:04:44Z | - |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | - |
dc.identifier.pmid | 30114230 | - |
Appears in Collections: | Articles publicats en revistes (Ciències Clíniques) Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) |
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