The cost implications of off-pump versus on-pump coronary artery bypass graft surgery at one year

Andre Lamy; Wesley Tong; P J Devereaux; Peggy Gao; Amiram Gafni; Kavita Singh; David Taggart; Zbyek Straka; Ahmet R Akar; Leopoldo Piegas; Yongning Ou; Salim Yusuf

doi:10.1016/j.athoracsur.2014.06.046

The cost implications of off-pump versus on-pump coronary artery bypass graft surgery at one year

Ann Thorac Surg. 2014 Nov;98(5):1620-5. doi: 10.1016/j.athoracsur.2014.06.046. Epub 2014 Sep 24.

Authors

Andre Lamy¹, Wesley Tong², P J Devereaux³, Peggy Gao⁴, Amiram Gafni⁵, Kavita Singh⁶, David Taggart⁷, Zbyek Straka⁸, Ahmet R Akar⁹, Leopoldo Piegas¹⁰, Yongning Ou⁴, Salim Yusuf³

Affiliations

¹ Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada; CADENCE Research Group, Hamilton Health Sciences, Hamilton, Ontario, Canada; Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada. Electronic address: [email protected].
² Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada; CADENCE Research Group, Hamilton Health Sciences, Hamilton, Ontario, Canada.
³ Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
⁴ Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
⁵ Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada; Center for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada.
⁶ All India Institute of Medical Sciences, New Delhi, India; Center for Chronic Disease Control, New Delhi, India.
⁷ Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom.
⁸ Third Faculty of Medicine, Charles University, Prague, Czech Republic.
⁹ Ankara University School of Medicine, Ankara, Turkey.
¹⁰ Unidade de Terapia Intensiva, Hospital do Coração, São Paulo, Brazil.

PMID: 25261272
DOI: 10.1016/j.athoracsur.2014.06.046

Abstract

Background: The purpose of this study was to determine the cost implications of the Coronary Artery Bypass Graft Off or On Pump Revascularization Study (CORONARY) at 1 year.

Methods: Country-specific healthcare costs were obtained from public databases or local experts from each country in the CORONARY trial. Purchasing power parities were applied to these costs of consumed healthcare resources. Analyses of subgroups included in the CORONARY clinical trial were also conducted. Costs are reported in US dollars.

Results: After 1 year, the total cost per patient in the off-pump coronary artery bypass graft surgery (CABG) arm was $9,650 ($9,216 to $10,285) compared with $9,583 ($9,239 to $9,988) for the on-pump CABG arm; that resulted in a nonsignificant increase of $68 (-$575 to $710). Similar findings were noted for various subgroups. There were also no differences due to late conversions.

Conclusions: The CORONARY trial demonstrated that off-pump CABG was clinically as safe and effective as on-pump CABG with no difference in costs. Thus, the decision as to which method to choose is free from costs considerations and should be based on patient preference and surgeon expertise (Coronary Artery Bypass Graft [CABG] Off or On Pump Revascularization Study [CORONARY]; clinicaltrials.gov NCT00463294).

Publication types

Comparative Study
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Coronary Artery Bypass / economics*
Coronary Artery Bypass, Off-Pump / economics
Coronary Artery Disease / economics
Coronary Artery Disease / surgery*
Cost-Benefit Analysis
Female
Health Care Costs
Humans
Male
Middle Aged
Retrospective Studies
Time Factors

Associated data

ClinicalTrials.gov/NCT00463294

Grants and funding

85214/Canadian Institutes of Health Research/Canada