059 Economic evaluation of the French subset of the SYNTAX trial at 1 year: drug-eluting stents compared with bypass surgery for patients with 3-vessel and/or left main coronary artery disease

Abstract

SYNTAX is a randomized controlled trial comparing percutaneous coronary intervention (PCI) using drug-eluting stents with coronary artery bypass graft surgery (CABG) in patients (pts) with 3 vessel and/or left main disease. We will analyze health economic data associated with CABG and PCI in the subset of France compared with select countries in the EU (Germany, Italy and UK). Costs will be estimated using 1-year resource utilization data including procedural resource use (stents, guidewires etc.), hospitalizations major procedures and work days lost. Estimates are based on French patterns of resource utilization, number of hospital days and break down of those in intensive care, or ward days. Where data did not allow reliable French estimate, a Bayesian statistical model was applied combining the observed resource utilization with priors based on data on less rare events. Effects are measured in terms of MACCE-free survival. In France, 105 pts were randomized to CABG and 103 to PCI in the SYNTAX trial. There were 156 hospitalizations in the first year in CABG pts compared with 139 in PCI pts. Overall, CABG pts in France spent 23.3 days (d) in hospital (see Table). PCI pts spent 9.2 d in hospital. After the index procedure, pts in the CABG arm spent 9.1 d in hospital whereas PCI pts spent 5.7 d. Economic data comparing short- and long-term medical care costs for pts with left main and/or 3-vessel CAD treated with either DES or CABG will be available at time of presentation. Additional analyses of the procedural resources utilized and costs associated with the procedures will be presented as a comparison between the French subset and countries in the EU. Mean Total Days in Hospital Per Patient * Mean Days in Hospital During Follow-up CABG PCI CABG PCI Intensive Care Unit (ICU) 8.8 4.3 1.8 1.3 General Ward 10.7 3.7 6.7 4.2 Other Wards 2.5 0.9 0.6 0.2 Total Days 23.3 9.2 9.1 5.7 * Total days in hospital includes days spent during index procedure