Cost Efficacy of Metal Stents for Palliation of XXXX in a Randomized Controlled Trial.

@entity6687 @entity1 @entity1702
BACKGROUND _ AIMS: Endoscopic stents are placed for palliation of @entity6687 . Although @entity1702 ( @entity1702 ) remain patent longer than plastic stents, they  are more expensive. We aimed to evaluate which type of stent  (plastic, uncovered @entity1702 [uSEMS], or partially covered @entity1702 [pcSEMS]) is the most effective and we assessed costs. METHODS: We performed a multicenter randomized trial in 219 @entity1 at 18 hospitals in The Netherlands from February 2008 through February 2013. @entity1 were assigned randomly for placement of a plastic stent (n  = 73), uSEMS (n  = 75), or pcSEMS (n  = 71) during endoscopic retrograde cholangiopancreatography. @entity1 were followed up for up to 1 year. Researchers were not blinded to groups. The main study end points included functional stent time and costs. RESULTS: The mean functional stent times were 172 days for plastic stents, 288 days for uSEMS, and 299 days for pcSEMS (P < .005 for uSEMS and pcSEMS vs plastic). The initial placement of plastic stents (   1042 or  1106) cost significantly less than placement of @entity1702 (   1973 or  2094) (P  = .001). However, the total cost per @entity1 at the end of the follow-up period did not differ significantly between plastic stents (   7320 or  7770) and @entity1702 (   6932 or  7356) (P  = .61). Furthermore, in @entity1 with short survival times ( <=3 mo) or metastatic disease, the total cost per @entity1 did not differ between plastic stents and @entity1702 . No differences in costs were found between pcSEMS and uSEMS. CONCLUSIONS: Although placement of @entity1702 (uncovered or partially covered) for palliation of @entity6687 initially is more expensive than placement of plastic stents, @entity1702 have longer functional time. The total costs after 1 year do not differ significantly with  stent type. Dutch Clinical Trial Registration no: NTR1361.
