OBJECTIVES: Recent studies have demonstrated that Resolute Integrity drug-eluting stent (RI-DES) was found to be non-inferior to Xience Xpedition drug-eluting stent (XX-DES) & Synergy drug-eluting stent (Synergy-DES). Given that the PCI cost can be impacted by choice of DES, this study is to evaluate the China hospital budget impact of using different DES combinations in hospitals.

METHODS: A budget impact model was developed to compare two scenarios: the implantation of RI-DES and XX-DES or RI-DES and Synergy-DES. The average PCI procedure volume was assumed as 1,500 per year. The baseline market share and the subsequent annual growth rate of DES were estimated based on the IQVIA data. PCI cost parameters were collected from electronic medical records and bills of 303 patients. The unit price of DES was taken from tender price. The budget difference between subsequent year and base year in two scenarios was calculated respectively.

RESULTS: RI-DES has higher average unit price, but lower average unit number used per PCI compared with XX-DES, which lowers total PCI cost. Under DRG payments, the use of RI-DES at 10% annual growth rate will generate ¥19,791 in 2020 and ¥39,582 in 2021 in hospital savings. RI-DES has same average unit number used per PCI, but lower average unit price compared to Synergy-DES, which reduces total PCI cost. Compared to Synergy-DES, hospitals increase the use of RI- DES at 10% annually, which will achieve savings ¥77,583 in 2020 and ¥155,166 in 2021. One-way sensitivity analysis indicated that the model is robust.

CONCLUSIONS: With no clinical efficacy difference demonstrated among RI-DES, XX-DES and Synergy-DES, under DRG systems, the increased use of RI-DES realizes considerable cost savings and create positive returns from the hospital perspective.