Cost analysis between stent and conventional balloon angioplasty

The present study evaluated the cost of coronary stenting compared with con ventional balloon angioplasty in Japan. Procedural cost was estimated as th e sum of the procedural fee and the cost of devices such as angioplasty bal loon and stent. The data such as the number of balloon catheters and stents used, and the rate of crossovers that was shown by the Stent Restenosis St udy (STRESS) were applied to calculate the costs of stenting and convention al balloon angioplasty. For the estimation of hospital room and nursing cos ts, the length of the in-hospital stay was estimated at 7 days. The costs o f procedures such as laboratory and radiological tests were determined base d on routine coronary intervention at Chiba University Hospital. The rates of target lesion revascularization in the STRESS trial (conventional balloo n angioplasty: 21%, stenting: 15%) were used to calculate the cost during f ollow up. The in-hospital costs of conventional balloon angioplasty and ste nting were estimated to be 982,300 Yen and 1,416,893, Yen respectively. The overall costs, including follow-up cost, of conventional balloon angioplas ty and stenting were estimated to be 1,188,583 Yen and 1,564,238, Yen respe ctively. The in-hospital cost of stenting is higher compared with conventio nal balloon angioplasty because of greater balloon use and direct stent cos t. Lower target lesion revascularization reduces the cost difference betwee n conventional balloon angioplasty and stenting, but the higher initial cos t of stenting is not fully offset.