Model parameters
| Values (mean (95% CI)) | Source | |
|---|---|---|
| APC, admitted patient care; ARTS, arterial revascularisation therapies study; CI, confidence interval; CT, computed tomography; CTC, Cardiothoracic Centre; PTCA, percutaneous transluminal coronary angioplasty; QALY, quality adjusted life year; SoS, stent or surgery. | ||
| Resource use | ||
| Cardiology consultations | ||
| Elective index PTCA | 2.10 (1.94 to 2.26) | CTC audit |
| Non-elective index PTCA | 1.05 (0.86 to 1.24) | |
| Angiography for recurrent symptoms | 1.0 | Assumed in absence of reliable data |
| Type of repeat procedure | ||
| After elective PTCA | CTC audit | |
| Balloon angioplasty | 36.6% (28.9% to 45.0%) | |
| Stented PTCA | 54.5% (46.0% to 62.7%) | |
| CABG | 9.0% (5.1% to 15.2%) | |
| After non-elective PTCA | CTC audit | |
| Balloon angioplasty | 27.4% (19.0% to 37.6%) | |
| Stented PTCA | 54.5% (44.2% to 64.9%) | |
| CABG | 17.9% (11.1% to 27.4%) | |
| Repeat PTCA stents used | ||
| Elective index PTCA | 1.87 (1.62 to 2.15) | CTC audit |
| Non-elective index PTCA | 1.71 (1.50 to 1.97) | |
| Follow up cardiology visits | ||
| Elective index PTCA | 2.18 (1.72 to 2.64) | CTC audit |
| Non-elective index PTCA | 1.80 (1.45 to 2.15) | |
| Follow up CT surgery visits | ||
| Elective index PTCA | 0.81 (0.42 to 1.20) | CTC audit |
| Non-elective index PTCA | 0.48 (0.23 to 0.74) | |
| Unit costs (£) | ||
| Cardiology | ||
| First outpatient visit | 130.44 | NHS tariff costs 2004/5 E15op deflated to 2003/4 prices |
| Follow up outpatient visit | 93.03 | NHS tariff costs 2004/5 E16op deflated to 2003/4 prices |
| Angiogram | 372.47 | NHS reference costs 2003 E02op |
| Elective PTCA | 3 190.00 | NHS APC spell costs 2004/5 E15 deflated to 2003/4 prices |
| Non-elective PTCA | 4 179.00 | |
| Elective CABG | 7 750.00 | NHS APC Spell Costs 2004/5 E04 deflated to 2003/4 prices |
| Non-elective CABG | 9 460.00 | |
| Cardiac surgery | NHS reference costs spec 170 adjusted by tariff costs cardiology ratios | |
| First outpatient visit | 214.39 | |
| Follow up outpatient visit | 171.67 | |
| Cost per uncoated stent | 370.00 | Market average |
| Price premium per drug eluting stent | 500.00 | List price difference (assumed baseline) |
| Utility | ||
| Annual QALYs lost to angina | 0.135 (0.122 to 0.148) | ARTS and SoS trials |
| QALYs lost per PTCA | 0.0056 (0.0051 to 0.0062) | |
| QALYs lost per CABG | 0.033 (0.031 to 0.035) | |
| Waiting time for revascularisation (weeks) | ||
| For balloon angioplasty after elective index PTCA | 27.3 (22.2 to 32.4) | CTC audit |
| For stented PTCA/CABG after elective index PTCA | 15.0 (12.1 to 18.0) | |
| For balloon angioplasty after non-elective index PTCA | 19.5 (13.3 to 25.7) | |
| For stented PTCA/CABG after non-elective index PTCA | 14.0 (9.6 to 18.4) | |