000 03725nam a22004217a 4500
008 210607s20212021 xxu||||| |||| 00| 0 eng d
022 _a2044-6055
024 _a10.1136/bmjopen-2020-044054 [doi]
024 _abmjopen-2020-044054 [pii]
024 _aPMC7875263 [pmc]
040 _aOvid MEDLINE(R)
099 _a33563623
245 _aCost-effectiveness analysis of percutaneous coronary intervention for single-vessel coronary artery disease: an economic evaluation of the ORBITA trial.
251 _aBMJ Open. 11(2):e044054, 2021 02 09.
252 _aBMJ Open. 11(2):e044054, 2021 02 09.
253 _aBMJ open
260 _c2021
260 _fFY2021
265 _sepublish
266 _d2021-02-18
520 _aCONCLUSIONS: The ICER for PCI compared with placebo, in patients with single-vessel coronary artery disease and angina on anti-anginal medication, exceeds the threshold of 30 000 used by the National Institute of Health and Care Excellence when undertaking health technology assessment for the NHS context. Trial registration: The ORBITA study is registered with ClinicalTrials.gov, number NCT02062593. Copyright (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.
520 _aDESIGN: A cost-effectiveness analysis comparing PCI with placebo. A Markov model was used to measure incremental cost-effectiveness, in cost per quality-adjusted life-years (QALYs) gained, over 12 months. Health utility weights were estimated using responses to the EuroQol 5-level questionnaire, from the Objective Randomised Blinded Investigation with optimal medical Therapy of Angioplasty in stable angina trial and UK preference weights. Costs of procedures and follow-up consultations were derived from Healthcare Resource Group reference costs and drug costs from the National Health Service (NHS) drug tariff. Probabilistic sensitivity analysis was undertaken to test the robustness of results to parameter uncertainty. Scenario analyses were performed to test the effect on results of reduced pharmaceutical costs in patients undergoing PCI, and the effect of patients crossing over from placebo to PCI due to refractory angina within 12 months.
520 _aINTERVENTIONS: At recruitment, patients received 6 weeks of optimisation of medical therapy for angina after which they were randomised to PCI or a placebo procedure.
520 _aOBJECTIVE: To evaluate the cost-effectiveness of percutaneous coronary intervention (PCI) compared with placebo in patients with single-vessel coronary artery disease and angina despite anti-anginal therapy.
520 _aOUTCOME MEASURES: Incremental cost-effectiveness ratio (ICER) expressed as cost (in ) per QALY gained for PCI compared with placebo.
520 _aPARTICIPANTS: 200 adult patients with stable angina and angiographically severe single-vessel coronary artery disease on anti-anginal therapy.
520 _aRESULTS: The estimated ICER is 90 218/QALY gained when using PCI compared with placebo in patients receiving medical treatment for angina due to single-vessel coronary artery disease. Results were robust under sensitivity analyses.
520 _aSETTING: Five UK NHS hospitals.
546 _aEnglish
650 _aIN PROCESS -- NOT YET INDEXED
651 _aMedStar Heart & Vascular Institute
657 _aJournal Article
657 _aResearch Support, Non-U.S. Gov't
700 _aWeintraub, William S
790 _aAl-Lamee R, Barnett AG, Boden WE, Francis D, Graves N, McCreanor V, Nowbar A, Parsonage WA, Rajkumar C, Weintraub WS
856 _uhttps://dx.doi.org/10.1136/bmjopen-2020-044054
_zhttps://dx.doi.org/10.1136/bmjopen-2020-044054
942 _cART
_dArticle
999 _c6171
_d6171