SPIRIT IV Results Published, Cost-Effectiveness Analysis Presented

May 5, 2010—Abbott Vascular (Santa Clara, CA) announced that Gregg W. Stone, MD, et al have published findings from the SPIRIT IV trial in the New England Journal of Medicine (2010;362:1663–1674). Abbott Vascular also announced that David Cohen, MD, presented findings from a retrospective cost-effectiveness analysis of SPIRIT IV data on March 13 at the Cardiovascular Research Foundation's Optimizing PCI Outcomes symposium in Atlanta.

According to the company, the published SPIRIT IV study results show that 1 year after a stenting procedure, patients treated with Abbott's Xience V everolimus-eluting coronary stent system were significantly less likely to have a major adverse event such as a myocardial infarction, repeat procedure, or cardiac death compared to patients treated with a Taxus Express² paclitaxel-eluting coronary stent system (Boston Scientific Corporation, Natick, MA). The SPIRIT IV trial also showed that patients treated with Xience V were considerably less likely to experience stent thrombosis compared to patients treated with the Taxus Express².

Dr. Stone originally presented these results on September 23, 2009 at the Transcatheter Cardiovascular Therapeutics (TCT) conference in San Francisco, which was reported in the October 2009 issue of Cardiac Interventions Today (2009;3:13–14).

Boston Scientific markets the Promus everolimus-eluting coronary stent system, a private-label version of Xience V, designed and manufactured by Abbott and supplied to Boston Scientific as part of a distribution agreement between the two companies.

The SPIRIT IV cost-effectiveness analysis was based on a retrospective review of prospectively collected medical resource utilization for all patients enrolled in the SPIRIT IV trial for initial hospitalization and 1 year after enrollment. Cardiovascular hospitalizations, revascularization procedures, diagnostic catheterization, and dual-antiplatelet therapy costs were included. The analysis assumed equal stent costs for the Xience V and Taxus stents.

According to Abbott Vascular, the analysis showed that the Xience V's clinical benefits translated into lower overall medical costs at 1 year after the stenting procedure. The 1-year total medical costs (initial hospitalization plus followup) were $146 lower for Xience V versus Taxus Express2. When nontarget vessel revascularization costs were excluded, the 1-year medical costs were $439 lower with Xience V versus Taxus Express² (P = .02).