<International Circulation>:  In China economic considerations must be analysed carefully such as the number of stents needed before a procedure can take place. What is your opinion on this?
    Dr Aaron Kugelmass: This also applies to the U.S as well， we have to think about how many stents we have to use and whether we should use multiple drug-eluting stents. In the United States the hospital costs are normally covered by either the government or by private insurance but the cost of the clopidogrel and the prasugrel which is very expensive is not and when patients cannot afford their medicine they stop taking their drugs leading to stent thrombosis. So， from the patient’s perspective even if the stents cost less money overall it is actually more expensive for the patient getting the stent than the bypass.  We in the U.S have to take into consideration both the overall cost to society but also the cost to the individual patient.

  《国际循环》：在中国，操作前需要仔细考虑经济因素，比如需要放几个支架？您怎么看这个问题？
    Kugelmass教授：在美国也是如此。我们也得考虑放几个支架。思考到底需不需要放置多个药物洗脱支架。在美国，医疗费用通常由美国政府或私人保险机构支付。但是，氯吡格雷和普拉格雷的费用不在支付范围内，这两个药都非常贵。当患者买不起药时，就没法继续吃药，进而导致支架内血栓的发生。因此，从患者的角度来考虑的话，尽管支架本身花费少，但是从总体上来讲，置入支架的花费要高于CABG。在美国，我们不但要考虑到治疗给社会带来的总体花费，还要考虑到每位患者的花费。

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