Stent costs decrease without warfarin

Investigators have found an overall decline in costs of stent cases when warfarin anticoagulation is abandoned.1 As stenting practice has evolved, concern has focused on the increasing delivery costs. To evaluate changes, researchers examined total costs; costs for catheterization, laboratory equipment, and equipment use; and nonlaboratory hospital costs for stents in two time periods, one involving routine warfarin anticoagulation and one in which warfarin was not used.
  • Overall costs dropped from the first period ($11,293 ± $7672) to the second ($9,819 ± $3,636).
  • Cath lab equipment expenditures rose from the first period ($3,823 ± $1,394) to the second ($4,278 ± $1,533).
  • Non-cath-lab hospital costs declined from the first period — $7,281 ± $7,179 — to the second — $5,560 ± $3,420.
The difference was most notable when considering the deletion of warfarin anticoagulation. Costs declined by $2,428 for patients in the period in which warfarin was not prescribed. The researchers conclude that, despite increasing costs of equipment, the overall cost of providing stents declined as warfarin anticoagulation was abandoned.

Reference

1. Vaitkus PT, Adele C, Wells SK, et al. The evolving costs of intracoronary stents. Am Heart J 1998; 136:132-135.