Table 1.
Resource use, costs, quality-adjusted life years, and cost-effectiveness at 10 year follow-up (intention-to-treat analysis)
| Mean resource use/adverse events at year 10 |
Mean total cost at year 10 |
|||||
|---|---|---|---|---|---|---|
| SITA (n = 1554) | BITA (n = 1548) | BITA vs. SITA Mean difference (95% CI, P-value) | SITA (n = 1554) | BITA (n = 1548) | BITA vs. SITA Mean difference (95% CI, P-value) | |
| Initial surgery | ||||||
| Index admission | 8819 | 9475 | 656 (101, 1212; 0.023) | |||
| Discharge cost | 562 | 532 | −30 (−353, 292; 0.848) | |||
| Healthcare contacts | ||||||
| GP visits | 32 | 31 | −0.67 (−2, 1; 0.461) | 1424 | 1405 | −19 (−100, 61; 0.627) |
| Nurse visits | 14 | 14 | 0.26 (−1, 2; 0.772) | 231 | 234 | 3 (−19, 25; 0.784) |
| Outpatient clinic visits | 10 | 11 | 0.84 (−1, 2; 0.222) | 1538 | 1683 | 145 (19, 271; 0.026) |
| Cardiac rehabilitation visits | 10 | 10 | −0.58 (−3, 2; 0.659) | 779 | 736 | −43 (−316, 230; 0.750) |
| Number of nights in hospitala | 2 | 2 | 0.42 (−0, 1; 0.196) | 716 | 875 | 159 (−163, 481; 0.318) |
| All health care contacts | 4689 | 4934 | 245 (−103, 594; 0.159) | |||
| Medications | ||||||
| Total medication | 35 | 35 | −0.09 (−1, 1; 0.881) | 218 | 222 | 5 (−6, 16; 0.383) |
| SAE treatmentb | ||||||
| Myocardial infarction | 53 | 52 | 0.98 (0.7, 1.4; 0.938) | 74 | 67 | −7 (−36, 22; 0.633) |
| Cerebrovascular accident | 63 | 45 | 0.72 (0.5, 1.1; 0.088) | 129 | 87 | −42 (−94, 10; 0.111) |
| Further CABG | 0 | 3 | 0 | 14 | 14 (−4, 31; 0.127) | |
| Further PCI | 157 | 154 | 0.98 (0.8, 1.2; 0.892) | 302 | 300 | −2 (−76, 73; 0.965) |
| Revascularization with catheter | 82 | 79 | 0.97 (0.7, 1.3; 0.832) | 100 | 107 | 7 (−46, 60; 0.784) |
| Sternal wound problems | 39 | 72 | 1.85 (1.3, 2.7; 0.002) | 101 | 276 | 175 (34, 316; 0.017) |
| Major bleeding | 11 | 10 | 0.91 (0.4, 2.1; 0.834) | 48 | 70 | 22 (−49, 93; 0.537) |
| Other AEs (cost of hospital stay only) | 1506 | 1749 | 1.17 (1.1, 1.2; 0.000) | 2201 | 2377 | 176 (−322, 675; 0.474) |
| Death (cost of hospital stay only) | 314 | 297 | 0.95 (0.8, 1.1; 0.522) | 405 | 363 | −41 (−262, 179; 0.703) |
| All adverse event costs | 3360 | 3662 | 302 (−290, 894; 0.304) | |||
| All costs | 17 647 | 18 825 | 1178 (204, 2152; 0.020) | |||
| Discounted total cost | 16 462 | 17 594 | 1133 (239, 2026; 0.015) | |||
| Life years | 9.03 | 9.05 | 0.02 (−0.15, 0.20; 0.801) | |||
| QALYsc | 6.57 | 6.54 | −0.01 (−0.2, 0.1; 0.883) | |||
| Incremental cost-effectiveness ratio: | BITA dominated [more expensive, less effective (non-significant)] | |||||
| Probability of cost-effectiveness at willingness to pay threshold | ||||||
| £13 000 | 29% | |||||
| £20 000 | 33% | |||||
| £30 000 | 36% | |||||
The cost of index admission includes the total cost of surgery [time in theatre (min), duration-related theatre costs and staff, duration-related anaesthetic costs, time on bypass (min), and other surgery costs (consumables, blood products, aprotinin), post-operative costs (ventilation time, intra-aortic balloon pump, inotropic support, renal support therapy, haemofiltration)] and any in hospital adverse events (myocardial infarction, cerebrovascular accident, further CABG, further PCI, revascularization with catheter, major bleed, other AEs (cost of hospital stay only), death (cost of hospital stay only)].
Number of nights in hospital exclusive of those associated with an ‘other’ adverse event or death.
SAE treatment is that occurring in the follow-up period only. The cost of SAEs which occurred during the index admission is included in the cost of index admission.
Estimated differences in QALYs are adjusted for baseline EQ-5D-3L index.