Cost-effectiveness of SeQuent®Please drug eluting balloon catheter for in-stent coronary restenosis under the Brazilian public health perspective

Abstract

Objectives: To evaluate the cost-effectiveness of paclitaxel eluting catheter (SeQuent®Please) for bare metal in-stent coronary restenosis in the perspective of the Brazilian Public Health System (SUS). Methods: A Markov model was developed to compare the drug-eluting balloon catheter with the standard of care alternatives available at SUS, even by lawsuits, including uncoated balloon angioplasty, angioplasty with bare metal stent implant and with paclitaxel-eluting stents with paclitaxel. Results: In all scenarios, the incremental cost-effectiveness ratios (ICER) have shown to be lower than 3 times the Brazilian GDP per capita in 2012. In the comparison with drug-eluting stents, results have shown cost-savings. Conclusion: Coronary angioplasty with paclitaxel coated balloon catheter for bare metal in-stent restenosis, compared to conventional angioplasty, would present additional costs for SUS budget, although its incorporation enable remarkably better management of in-stent restenosis, besides to aggregate important therapeutic effect for the patients suffering this sort of illness.