A Systematic Review of Economic Evaluations of Balloons and Stents for Patients With Coronary Artery Disease Undergoing Percutaneous Coronary Intervention

OBJECTIVES: This study aims to systematically review economic evaluations of balloons and stents (BAS) for coronary artery diseases (CADs), and summarize the special considerations for the distinctiveness of BAS compared with drugs.

METHODS: The PubMed, Web of Science, Embase, Cochrane Library, Elsevier ScienceDirect, Cost-Effectiveness Analysis Registry and National Health Service Economic Evaluation Database were electronically searched from May 2012 to May 2022. Two reviewers independently screened the literature, extracted data, and evaluated the quality of included studies using the Consolidated Health Economic Evaluation Reporting Standards 2022 checklist and the Quality of Health Economic Studies checklist.

RESULTS: A total of 914 articles were initially retrieved, and 21 economic evaluations were included for analysis. Characteristics, target population, study perspective, interventions and comparators, analysis approaches, costs and health outcomes related to special considerations for economic evaluations of BAS were summarized. Dynamic pricing, influence of long-term dual antiplatelet therapy, and effectiveness of stents of varying number, length and diameter were considered in current studies. However, other suggested special considerations about incremental innovation, learning curve effects and organizational impact have not been mentioned in these studies.

CONCLUSIONS: This study summarized the characteristics of economic evaluations of BAS for CADs and highlighted the particularities of medical devices compared with drugs and how these were addressed in existing studies. To reduce the uncertainty of economic evaluations of BAS, further studies are recommended to ensure that specific characteristics compared with drugs are fully accounted for.