• Belinda González-Díaz, Juan Garduño-Espinosa, Guillermo Salinas-Escudero, Alfonso Reyes-López, and Víctor Granados-García.
• Department of Hemodynamics, Hospital de Cardiología, Unidad Médica de Alta Especialidad, CMN-SXXI, Instituto Mexicano del Seguro Social (IMSS), México, D.F., México.
• Rev Invest Clin. 2015 Jul 1; 67 (4): 219-26.

BackgroundThe value of drug-eluting stents in preventing cardiovascular events has not been investigated in Mexico.ObjectiveTo conduct a cost-effectiveness analysis of early and new-generation drug-eluting stents from the perspective of a healthcare provider.MethodsWe conducted a cost-effectiveness analysis of early and new-generation drug-eluting stents in patients with ischemic cardiomyopathy attending a Cardiology Hospital of the Mexican Social Security Institute. The health endpoint used was major acute cardiovascular events prevented. The effectiveness by stent type was obtained from the literature. A retrospective chart review study was conducted to collect cost data on cardiovascular events including seven cost categories. Average and incremental cost-effectiveness ratios were estimated. Deterministic and probabilistic sensitivity analyses were performed to test the robustness of estimates.ResultsIncremental cost-effectiveness ratios in base-case were 28,910 and US$ 35,590 for early and new-generation stents, respectively. In an optimal scenario, incremental-cost effectiveness ratio was 24,776 and US$ 25,262 for early and new stents, respectively. Probabilistic sensitivity analysis suggested that 90% of cases were cost-effective when willingness-to-pay was 58,000 and US$ 66,000 for early and new-generation stents, respectively.ConclusionsThe cost-effectiveness ratios of early and new-generation stents were significantly higher than corresponding bare-metal stents.

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