Comparison of the Economic Burden Between Coronary Artery Bypass Grafting and Percutaneous Coronary Intervention at a One-Year Follow-up

Document Type : Original Article

Authors

1 Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran.

2 School of Health, Tehran University of Medical Sciences, Tehran, IR Iran.

Abstract

Background: Cardiovascular disease is one of the leading causes of death and disability in the world. There is limited information about the economic burden of this disease in Iran. This study aimed to compare the economic burden between coronary artery bypass grafting surgery (CABG) and percutaneous coronary intervention (PCI) from 2018 through 2019.
 
Methods: The cost of cardiovascular disease was calculated from a sociological perspective based on a top-down approach. The study samples were 379 cardiac patients with venous congestion above 70% who were sampled at Tehran Heart Center by simple random sampling. The cost information was collected in 3 different periods using the hospital information system and interviewing patients.
 
Results: The direct medical cost of CABG was higher than that of PCI (183 907 460 rials vs 122 508 920 rials). The direct nonmedical cost and the indirect cost of CABG were 15 848 570 rials and 79 420 960 rials, respectively, while these costs were 7 951 900 rials and 26 315 170 rials, respectively, for PCI.
 
Conclusions: At 1 year’s postoperative follow-up, CABG had a higher cost than PCI for the patients and, thus, the country’s healthcare system. (Iranian Heart Journal 2022; 23(1): 106-111)

Keywords

References

  1. Cardiovascular Diseases. Available from: https://www.who.int/health-topics/cardiovascular-diseases/#tab=tab_1.
  2. IfHMa E. Global Burden of Disease (GBD) study 2016. Available from: http://www.healthdata.org/iran.
  3. Taggart PCI or CABG in coronary artery disease? The Lancet. 2009;373(9670):1150-2.
  4. Lee H, Lee KS, Sim SB, Jeong HS, Ahn HM, Chee HK. Trends in Percutaneous Coronary Intervention and Coronary Artery Bypass Surgery in Korea. The Korean journal of thoracic and cardiovascular surgery. 2016; 49(Suppl 1):S60.
  5. Epstein AJ, Polsky D, Yang F, Yang L, Groeneveld PW. Coronary revascularization trends in the United States, 2001-2008. Jama. 2011; 305(17):1769-76.
  6. Stuntz M, Palak A. Recent trends in percutaneous coronary intervention volume in the United States. Value in Health. 2016; 19(7):A641.
  7. Federation WH. The costs of CVD. Available from: http://www.championadvocates.org/en/champion-advocates-programme/the-costs-of-cvd.
  8. Raghfar H, Sargazi N, Mehraban S, Akbarzadeh M, Vaez Mahdavi M, Vahdati Manesh Z. The economic burden of coronary heart disease in Iran: a bottom-up approach in 2014. Journal of Ardabil University of Medical Sciences. 2018; 18(3):341-56.
  9. Emamgholipour S, Akbari Sari A, Geravandi S, Mazrae H. Estimation of Out-of-Pocket and Catastrophic Expenditures among Patients with Cardiovascular Diseases in Khuzestan. Payavard Salamat. 2017; 11(3):297-307. eng.
  10. Stone GW, Kappetein AP, Sabik JF, Pocock SJ, Morice M-C, Puskas J, et al. Five-year outcomes after PCI or CABG for left main coronary disease. New England Journal of Medicine. 2019; 381(19):1820-30.
  11. Brandão SMG, Rezende PC, Brunner-La Rocca H-P, Ju YT, de Lima ACP, Takiuti ME, et al. Comparative cost-effectiveness of surgery, angioplasty, or medical therapy in patients with multivessel coronary artery disease: MASS II trial. Cost Effectiveness and Resource Allocation. 2018; 16(1):55.
  12. Milojevic M, Head SJ, Parasca CA, Serruys PW, Mohr FW, Morice M-C, et al. Causes of death following PCI versus CABG in complex CAD: 5-year follow-up of SYNTAX. Journal of the American College of Cardiology. 2016; 67(1):42-55.
  13. Jo C. Cost-of-illness studies: concepts, scopes, and methods. Clinical and molecular hepatology. 2014 Dec;20(4):327-37. PubMed PMID: 25548737. Pubmed Central PMCID: PMC4278062. Epub 2014/12/31. eng.
  14. Sarrafzadegan N, Sadeghi M, Oveisgharan S, Iranipour R. Incidence of cardiovascular diseases in an Iranian population: the Isfahan Cohort Study. Archives of Iranian medicine. 2013;16(3):138.
  15. Evaluation IfHMa. Global Burden of Disease (GBD) study 2016. Available from: http://ghdx.healthdata.org/gbd-results-tool.
  16. Emamgholipour S, Sari AA, Pakdaman M, Geravandi S. Economic Burden of Cardiovascular Disease in the Southwest of Iran. International Cardiovascular Research Journal. 2018; 12(1)
  17. Chang H-S, Kim H-J, Nam C-M, Lim S-J, Jang Y-H, Kim S, et al. The socioeconomic burden of coronary heart disease in Korea. Journal of Preventive Medicine and Public Health. 2012; 45(5):291.
  18. colleague ZZa. Cost-effectiveness of CABG vs PCI for Treatment of Multivessel Coronary Disease among Unstable Angina Patients---A Secondary Analysis from ASCERT. Circulation. 2014.
  19. David J. Cohen RLO, Elizabeth A. Magnuson ADN colleague. Cost-Effectiveness of Percutaneous Coronary Intervention With Drug-Eluting Stents Versus Bypass Surgery for Patients With 3-Vessel or Left Main Coronary Artery Disease. Circulation. 2014.
Iranian Heart Journal
Volume 23, Issue 1
January 2022
Pages 106-111

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