Cost-effectiveness of intravascular ultrasound-guided percutaneous intervention in patients with acute coronary syndromes: a United Kingdom (UK) perspective
Authors' conclusion
From a UK healthcare perspective, an IVUS-guided PCI strategy was highly cost-effective over angiography alone amongst ACS patients undergoing DES implantation due to the medium- and long-term reduction in repeat PCI, death, and MI.
Study context
- Population
- Hypothetical adult ST-elevation myocardial infarction (STEMI) and UA/NSTEMI populations undergoing drug-eluting stent (DES) implantationper hypothetical population
- Participants
- 1,000 participants
- Comparison
- Intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) vs angiography alone
- Outcome
- Incremental cost-effectiveness ratio
- Follow-up
- Lifetime horizon
Methodological detailsdecision tree and lifetime Markov model, 1-year decision tree, UK healthcare system perspective, 2019/20 costs, hypothetical populations
- Decision tree and lifetime Markov model
- 1-year decision tree
- UK healthcare system perspective
- 2019/20 costs
- Hypothetical populations
Main finding
As reported in the abstract
ICER, STEMI
£3649 per-patient
ICER, UA/NSTEMI
£5706 per-patient
Further findings
Reductions with IVUS (model): mortality, myocardial infarction (MI), repeat PCI · 1-year time horizon
- STEMI: mortality reduction
- 51%
- STEMI: MI reduction
- 33%
- STEMI: repeat PCI reduction
- 52%
- UA/NSTEMI: mortality reduction
- 50%
- UA/NSTEMI: MI reduction
- 29%
- UA/NSTEMI: repeat PCI reduction
- 57%
Sensitivity analyses
- IVUS cost-effective at willingness-to-pay threshold of £20 000 per QALY-gained
- 100%
Original publication
Cost-effectiveness of intravascular ultrasound-guided percutaneous intervention in patients with acute coronary syndromes: a UK perspective. Eur Heart J Qual Care Clin Outcomes. Published 18 December 2023. doi:10.
Summarised from the published abstract; every number is checked against it