A comparison of costs and effectiveness of coronary revascularisation strategies in the Australian context

The cost-effectiveness of high-cost drug-eluting stents (DES) when compared with surgery, and bare metal stents (BMS), is unknown among Australian patients. This thesis addressed this gap through economic evaluations using data collected from real-world clinical practice for high-risk patients. At early follow-up, coronary bypass surgery was cost-effective when compared with stents among multivessel coronary artery disease patients with diabetes, acute coronary syndrome, left-main disease, or heart failure. The use of DES compared with BMS was associated with cost savings to the healthcare payer if patients had ≥3 indications for a DES. These results may inform payers and evidence-based clinical practice.