IDEAS home Printed from https://ideas.repec.org/a/spr/eujhec/v21y2020i8d10.1007_s10198-020-01235-3.html
   My bibliography  Save this article

Economic evaluation of culprit lesion only PCI vs. immediate multivessel PCI in acute myocardial infarction complicated by cardiogenic shock: the CULPRIT-SHOCK trial

Author

Listed:
  • Jose Antonio Robles-Zurita

    (University of Glasgow)

  • Andrew Briggs

    (London School of Hygiene & Tropical Medicine)

  • Dikshyanta Rana

    (University of Glasgow)

  • Zahidul Quayyum

    (BRAC James P Grant School of Public Health, BRAC University)

  • Keith G. Oldroyd

    (Golden Jubilee National Hospital)

  • Uwe Zeymer

    (Klinikum Ludwigshafen and Institut für Herzinfarktforschung)

  • Steffen Desch

    (University of Leipzig and Leipzig Heart Institute)

  • Suzanne Waha-Thiele

    (University Heart Center Lübeck, University Hospital Schleswig-Holstein (UKSH))

  • Holger Thiele

    (University of Leipzig and Leipzig Heart Institute)

Abstract

Background The CULPRIT-SHOCK trial compared two treatment strategies for patients with acute myocardial infarction and multivessel coronary artery disease complicated by cardiogenic shock: (a) culprit vessel only percutaneous coronary intervention (CO-PCI), with additional staged revascularisation if indicated, and (b) immediate multivessel PCI (MV-PCI). Methods A German societal and national health service perspective was considered for three different analyses. The cost utility analysis (CUA) estimated costs and quality adjusted life years (QALYs) based on a pre-trial decision analytic model taking a lifelong time horizon. In addition, a within trial CUA estimated QALYs and costs for 1 year. Finally, the cost effectiveness analysis (CEA) used the composite primary outcome, mortality and renal failure at 30-day follow-up, and the within trial costs. Econometric and survival analysis on the trial data was used for the estimation of the model parameters. Subgroup analysis was performed following an economic protocol. Results The lifelong CUA showed an incremental cost effectiveness ratio (ICER), CO-PCI vs. MV-PCI, of €7010 per QALY and a probability of CO-PCI being the most cost-effective strategy > 64% at a €30,000 threshold. The ICER for the within trial CUA was €14,600 and the incremental cost per case of death/renal failure avoided at 30-day follow-up was €9010. Cost-effectiveness improved with patient age and for those without diabetes. Conclusions The estimates of cost-effectiveness for CO-PCI vs. MV-PCI have been shown to change depending on the time horizon and type of economic evaluation performed. The results favoured a long-term horizon analysis for avoiding underestimation of QALY gains from the CO-PCI arm.

Suggested Citation

  • Jose Antonio Robles-Zurita & Andrew Briggs & Dikshyanta Rana & Zahidul Quayyum & Keith G. Oldroyd & Uwe Zeymer & Steffen Desch & Suzanne Waha-Thiele & Holger Thiele, 2020. "Economic evaluation of culprit lesion only PCI vs. immediate multivessel PCI in acute myocardial infarction complicated by cardiogenic shock: the CULPRIT-SHOCK trial," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(8), pages 1197-1209, November.
  • Handle: RePEc:spr:eujhec:v:21:y:2020:i:8:d:10.1007_s10198-020-01235-3
    DOI: 10.1007/s10198-020-01235-3
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s10198-020-01235-3
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.

    File URL: https://libkey.io/10.1007/s10198-020-01235-3?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Melina Dritsaki & Alastair Gray & Stavros Petrou & Susan Dutton & Sarah E. Lamb & Joanna C. Thorn, 2018. "Current UK Practices on Health Economics Analysis Plans (HEAPs): Are We Using Heaps of Them?," PharmacoEconomics, Springer, vol. 36(2), pages 253-257, February.
    2. W. Greiner & C. Claes & J. J. V. Busschbach & J.-M. Schulenburg, 2005. "Validating the EQ-5D with time trade off for the German population," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(2), pages 124-130, June.
    Full references (including those not matched with items on IDEAS)

    Citations

    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 26th October 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-10-26 12:00:03

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Mathieu F. Janssen & A. Simon Pickard & James W. Shaw, 2021. "General population normative data for the EQ-5D-3L in the five largest European economies," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(9), pages 1467-1475, December.
    2. Claudia Schulz & Gisela Büchele & Raphael S. Peter & Dietrich Rothenbacher & Christian Brettschneider & Ulrich C. Liener & Clemens Becker & Kilian Rapp & Hans-Helmut König, 2021. "Health-economic evaluation of collaborative orthogeriatric care for patients with a hip fracture in Germany: a retrospective cohort study using health and long-term care insurance claims data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(6), pages 873-885, August.
    3. Carl Tilling & Marieke Kro & Aki Tsuchiya & John Brazier & Job Exel & Werner Brouwer, 2012. "Does the EQ-5D Reflect Lost Earnings?," PharmacoEconomics, Springer, vol. 30(1), pages 47-61, January.
    4. Irina Cleemput, 2010. "A social preference valuations set for EQ-5D health states in Flanders, Belgium," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(2), pages 205-213, April.
    5. Hildegard Seidl & Matthias Hunger & Reiner Leidl & Christa Meisinger & Rupert Wende & Bernhard Kuch & Rolf Holle, 2015. "Cost-effectiveness of nurse-based case management versus usual care for elderly patients with myocardial infarction: results from the KORINNA study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(6), pages 671-681, July.
    6. Pepijn Vemer & Maureen Rutten-van Mölken, 2013. "The Road Not Taken: Transferability Issues in Multinational Trials," PharmacoEconomics, Springer, vol. 31(10), pages 863-876, October.
    7. Eleanor Pullenayegum & Kuhan Perampaladas & Kathryn Gaebel & Brett Doble & Feng Xie, 2015. "Between-country heterogeneity in EQ-5D-3L scoring algorithms: how much is due to differences in health state selection?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(8), pages 847-855, November.
    8. Raymond Oppong & Billingsley Kaambwa & Jacqueline Nuttall & Kerenza Hood & Richard Smith & Joanna Coast, 2013. "The impact of using different tariffs to value EQ-5D health state descriptions: an example from a study of acute cough/lower respiratory tract infections in seven countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(2), pages 197-209, April.
    9. Richard Dodel & Svenja Happe & Ines Peglau & Geert Mayer & Jürgen Wasem & Jens-Peter Reese & Guido Giani & Max Geraedts & Claudia Trenkwalder & Wolfgang Oertel & Karin Stiasny-Kolster, 2010. "Health Economic Burden of Patients with Restless Legs Syndrome in a German Ambulatory Setting," PharmacoEconomics, Springer, vol. 28(5), pages 381-393, May.
    10. A. Konnopka & M. Bödemann & H.-H. König, 2011. "Health burden and costs of obesity and overweight in Germany," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(4), pages 345-352, August.
    11. Hans-Helmut König & Oliver Günther & Matthias Angermeyer & Christiane Roick, 2009. "Utility Assessment in Patients with Mental Disorders," PharmacoEconomics, Springer, vol. 27(5), pages 405-419, May.
    12. Munir A. Khan & Jeff Richardson, 2019. "Is the Validity of Cost Utility Analysis Improved When Utility is Measured by an Instrument with ‘Home-Country’ Weights? Evidence from Six Western Countries," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 145(1), pages 1-15, August.
    13. Rodríguez-Míguez, E. & Abellán-Perpiñán, J.M. & Alvarez, X.C. & González, X.M. & Sampayo, A.R., 2016. "The DEP-6D, a new preference-based measure to assess health states of dependency," Social Science & Medicine, Elsevier, vol. 153(C), pages 210-219.
    14. Dirk Müller & Marion Danner & Kerstin Rhiem & Björn Stollenwerk & Christoph Engel & Linda Rasche & Lisa Borsi & Rita Schmutzler & Stephanie Stock, 2018. "Cost-effectiveness of different strategies to prevent breast and ovarian cancer in German women with a BRCA 1 or 2 mutation," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(3), pages 341-353, April.
    15. Kyra Kneis & Afschin Gandjour, 2009. "Economic evaluation of Sinfrontal®in the treatment of acute maxillary sinusitis in adults," Applied Health Economics and Health Policy, Springer, vol. 7(3), pages 181-191, September.
    16. Anja Schwalm & You-Shan Feng & Jörn Moock & Thomas Kohlmann, 2015. "Differences in EQ-5D-3L health state valuations among patients with musculoskeletal diseases, health care professionals and healthy volunteers," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(8), pages 865-877, November.
    17. Chunmei Wu & Yanhong Gong & Jiang Wu & Shengchao Zhang & Xiaoxv Yin & Xiaoxin Dong & Wenzhen Li & Shiyi Cao & Naomie Mkandawire & Zuxun Lu, 2016. "Chinese Version of the EQ-5D Preference Weights: Applicability in a Chinese General Population," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-16, October.
    18. Daniela Eidt-Koch & Wolfgang Greiner, 2011. "Quality of life results of balloon kyphoplasty versus non surgical management for osteoporotic vertebral fractures in Germany," Health Economics Review, Springer, vol. 1(1), pages 1-7, December.

    More about this item

    Keywords

    Culprit-shock trial; Economic evaluation; Pre-trial model; Decision analytic modelling;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:eujhec:v:21:y:2020:i:8:d:10.1007_s10198-020-01235-3. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: . General contact details of provider: http://www.springer.com .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.