Pharmacoeconomic evaluation of intravascular ultrasound for imaging in cardiac interventions

Abstract

Introduction: Intravascular ultrasound (IVUS) is an imaging modality used primarily in interventional cardiology to characterize lesion morphology, quantify plaque significance, guide stent sizing, assess stent implantation, and identify procedural complications. Aim: This analysis aims to present a cost-effectiveness analysis and budget impact analysis of intravascular ultrasound for imaging in patients undergoing cardiac catheterization and percutaneous coronary interventions. Material and methods: A model evaluating the cost-effectiveness of IVUS-guided PCI versus PCI with the classic angiography-guided strategy was created. The analyses used a healthcare perspective of the payer - the National Health Insurance Fund (NHIF). The economic method chosen to evaluate IVUS is of the cost-utility analysis type. In addition, a cost-effectiveness analysis was conducted. Health benefits for patients in the applied model were measured as quality-adjusted life years (QALYs) and life-years added (LYs). Results: Performing IVUS-guided PCI generated an additional total cost of BGN 2,329.40 at 0.2660 additional QALYs and 0.4932 LYs gained, compared with PCI guided by conventional coronary angiography in patients with STEMI. Similarly, performing IVUS-guided PCI gener-ated an additional total cost of BGN 2,213.11 at 0.1363 additional QALYs and 0.2457 LYs gained, compared with PCI guided by conventional coronary angiography in patients with UA/NSTEMI. Conclusion: The IVUS-guided PCI strategy is a cost-effective option for intravascular imaging.

Keywords

• intravascular ultrasound
• IVUS
• ischemic heart dis