VIEWPOINT

Can the published cost analysis data for delivery of an efficient primary angioplasty service be applied to the modern National Health Service?

N Melikian^*, K Morgan, K J Beatt

Cardiology Department, Hammersmith Hospital, London, UK

Correspondence to:
Correspondence to:
Dr K Beatt
Cardiac Catheter Suite, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK; k.beatt{at}imperial.ac.uk

Despite the clinical benefits and safety profile of primary percutaneous coronary intervention (PCI), the health care system in the UK has been slow to adopt this strategy as first line management for ST segment elevation myocardial infarction. The cost implications of a 24 hour a day, seven days per week primary PCI service and the absence of an existing efficient working model within the National Health Service (NHS) framework are two of the major deterrents for provision of such a service. The existent cost effectiveness data for primary PCI is critically reviewed, with particular reference to the NHS.

Abbreviations: NHS, National Health Service; PCI, percutaneous coronary intervention; PAMI, primary angioplasty in myocardial infarction; POBA, plain old balloon angioplasty; rt-PA, recombinant tissue plasminogen activator; STEMI, ST elevation myocardial infarction; QALY, quality adjusted life-year

Keywords: primary angioplasty; cost effectiveness; National Health Service; NHS

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