Use of CYPHER stent in diabetic patients can result in significant cost savings

New analysis presented at the Transcatheter Cardiovascular Therapeutics meeting (TCT 2010) in Washington, DC, indicates that the broad use of CYPHER® Sirolimus-eluting coronary stent in patients with diabetes would result in substantial cost savings, as compared to the use of everolimus-eluting stents (EES), paclitaxel-eluting stents (PES), or zotarolimus-eluting stents (ZES). Diabetic patients are a population at elevated risk of needing repeat coronary procedures and also pose a significant cost burden to the health care system.

“This study adds to the large body of evidence assessing the economic value of drug-eluting stents”

According to this analysis, the cost reduction per diabetic patient treated with CYPHER® would range between $733 and $937 depending on comparator drug-eluting stent (DES). When this analysis is extrapolated to an estimated 200,000 US diabetics that undergo percutaneous coronary intervention (PCI) with DES implantation each year, the annual cost savings with CYPHER® would exceed $145 million vs. all three other DES (EES, PES, or ZES).

This study reflects the growing attention to Comparative Effectiveness Research, a focal issue in the recent health care reform debate. "This study adds to the large body of evidence assessing the economic value of drug-eluting stents," said Ryan Saadi, M.D., M.P.H., Worldwide Vice President of Health Economics and Strategic Pricing. "It is unique in that it includes all relevant stents and predicts the actual costs for an entire population of patients, in this case diabetic patients that qualify under a fixed fee reimbursement system like Medicare. We look forward to presenting our analysis in other important patient sub-groups in the future."

The analysis was based on the rates of target lesion revascularization (TLR) at 1 year among 4,853 patients with diabetes in 13 head-to-head clinical trials of various DES, all of which included the PES. When outcomes from these trials are combined using an indirect comparisons framework, the rate of TLR at 1 year in diabetic patients treated with PES was estimated to be 6.9%. The use of either EES or ZES was not associated with a significant relative risk reduction in 1-year TLR vs. PES The 1-year TLR rates were estimated to be 7.9% for EES and 7.1% for ZES). In contrast, the use of CYPHER® led to a highly significant, 54% relative risk reduction in the rate of 1-year TLR (3.2%) vs. the PES (P<0.001). When these results are applied to the fixed-fee reimbursement system used in the US, and the costs of the index PCI (with DES) and re-intervention for TLR were estimated at $17,500 and $19,594, respectively, the annual cost savings per patient treated with CYPHER® were shown to be over $700 vs. all three other DES (EES, PES, or ZES).

NOTE: Neither the CYPHER stent, nor any other DES sold in the U.S., has an FDA-approved indication for use in patients with diabetes.