Annual cost of stable coronary artery disease in France: A modeling study

Summary Background Few studies have analyzed the cost of treatment of chronic angina pectoris, especially in European countries. Aim To determine, using a modeling approach, the cost of care in 2012 for 1 year of treatment of patients with stable angina, according to four therapeutic options: optimal medical therapy (OMT); percutaneous coronary intervention with bare-metal stent (PCI-BMS); PCI with drug-eluting stent (PCI-DES); and coronary artery bypass graft (CABG). Methods Six different clinical scenarios that could occur over 1 year were defined: clinical success; recurrence of symptoms without hospitalization; myocardial infarction (MI); subsequent revascularization; death from non-cardiac cause; and cardiac death. The probability of a patient being in one of the six clinical scenarios, according to the therapeutic options used, was determined from a literature search. A direct medical cost for each of the therapeutic options was calculated from the perspective of French statutory health insurance. Results The annual costs per patient for each strategy, according to their efficacy results, were, in our models, € 1567 with OMT, € 5908 with PCI-BMS, € 6623 with PCI-DES and € 16,612 with CABG. These costs were significantly different ( P Conclusion OMT appears to be the least costly option, and, if reasonable from a clinical point of view, might achieve appreciable savings in health expenditure.