The cost-effectiveness of radial access percutaneous coronary intervention: A propensity-score matched analysis of Victorian data.
acute coronary syndrome
cost-effectiveness
health economics
percutaneous coronary intervention
Journal
Clinical cardiology
ISSN: 1932-8737
Titre abrégé: Clin Cardiol
Pays: United States
ID NLM: 7903272
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
revised:
23
01
2022
received:
26
09
2021
accepted:
03
02
2022
pubmed:
23
2
2022
medline:
22
4
2022
entrez:
22
2
2022
Statut:
ppublish
Résumé
Despite evidence of the comparative benefits of transradial access percutaneous coronary intervention (PCI) over transfemoral access, its uptake remains highly varied across Australia. Few studies have explored the implications of the choice of access site during PCI from the perspective of the Australian healthcare setting. We, therefore, performed a cost-effectiveness analysis of radial versus femoral access PCI. Data from the Victorian Cardiac Outcomes Registry (VCOR) were used to inform our economic analyses. Patients treated through either radial or femoral access PCI were propensity score-matched using the inverse probability weighted (IPW) method, and the incidence of major bleeding and all-cause mortality in the cohort was used to inform an economic model comprising a hypothetical sample of 1000 patients. Costs and utility data were drawn from published sources. The economic evaluation adopted the perspective of the Australian healthcare system. Among a cohort of 1000 patients over 1 year, there were 19 fewer deaths, and six fewer episodes of nonfatal major bleeding in the radial group compared to the femoral group. Total cost savings attributed to radial access was AUD $1 214 688. Hence, from a health economic point of view, radial access PCI was dominant over femoral access PCI. Sensitivity analyses supported the robustness of these findings. Radial access is associated with improved patient outcomes and considerably lower costs relative to femoral access PCI. Our findings support radial access being the preferred approach for PCI across a variety of indications in Australia.
Sections du résumé
BACKGROUND
BACKGROUND
Despite evidence of the comparative benefits of transradial access percutaneous coronary intervention (PCI) over transfemoral access, its uptake remains highly varied across Australia. Few studies have explored the implications of the choice of access site during PCI from the perspective of the Australian healthcare setting. We, therefore, performed a cost-effectiveness analysis of radial versus femoral access PCI.
METHODS
METHODS
Data from the Victorian Cardiac Outcomes Registry (VCOR) were used to inform our economic analyses. Patients treated through either radial or femoral access PCI were propensity score-matched using the inverse probability weighted (IPW) method, and the incidence of major bleeding and all-cause mortality in the cohort was used to inform an economic model comprising a hypothetical sample of 1000 patients. Costs and utility data were drawn from published sources. The economic evaluation adopted the perspective of the Australian healthcare system.
RESULTS
RESULTS
Among a cohort of 1000 patients over 1 year, there were 19 fewer deaths, and six fewer episodes of nonfatal major bleeding in the radial group compared to the femoral group. Total cost savings attributed to radial access was AUD $1 214 688. Hence, from a health economic point of view, radial access PCI was dominant over femoral access PCI. Sensitivity analyses supported the robustness of these findings.
CONCLUSIONS
CONCLUSIONS
Radial access is associated with improved patient outcomes and considerably lower costs relative to femoral access PCI. Our findings support radial access being the preferred approach for PCI across a variety of indications in Australia.
Identifiants
pubmed: 35191069
doi: 10.1002/clc.23798
pmc: PMC9019896
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
435-446Informations de copyright
© 2022 The Authors. Clinical Cardiology published by Wiley Periodicals, LLC.
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