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Related Experiment Videos

Economic issues in glycoprotein IIb/IIIa receptor therapy.

W B Hillegass1, A R Newman, D L Raco

  • 1Vanderbilt University Medical Center, Nashville, TN 37232-6300, USA.

American Heart Journal
|July 1, 1999
PubMed
Summary

Glycoprotein IIb/IIIa inhibitors are effective and safe for acute coronary syndromes and PCI. Economic data show variable costs but potential cost savings, with cost-effectiveness ratios varying by patient group.

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Area of Science:

  • Cardiology
  • Health Economics
  • Pharmacology

Background:

  • Glycoprotein IIb/IIIa inhibitors are crucial in managing acute coronary syndromes (ACS) and percutaneous coronary intervention (PCI).
  • Decisions regarding their use hinge on efficacy, safety, and cost-effectiveness.
  • Abciximab, eptifibatide, and tirofiban are key agents in this class.

Purpose of the Study:

  • To review economic data on Glycoprotein IIb/IIIa inhibitor therapy.
  • To aid clinical decision-making by assessing cost-effectiveness in ACS and PCI.
  • To analyze procurement costs and cost savings associated with these therapies.

Main Methods:

  • Review of economic data from prospective randomized studies and PCI trials.
  • Analysis of procurement costs per patient for different regimens.

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  • Calculation of cost-effectiveness ratios (e.g., cost per death prevented, cost per life-year saved).

    • Main Results:

    • Procurement costs for Glycoprotein IIb/IIIa inhibitors range from $436-$1407 per patient in PCI and $1050-$1548 in ACS.
    • Economic substudies show partial offset of drug costs by medical cost savings in PCI.
    • Cost-effectiveness ratios for PCI range from $13,000-$37,000 per event prevented and $4000-$7000 per life-year saved with abciximab.
    • For ACS, expenditures per event prevented range from $32,000-$82,000, with cost-effectiveness unclear for most patients.

    Conclusions:

    • Glycoprotein IIb/IIIa inhibitor therapy demonstrates superior efficacy and safety in ACS and PCI.
    • Economic data suggest partial cost offsets and varying cost-effectiveness, particularly in PCI.
    • Cost-effectiveness is likely limited to high-risk ACS patients, with further data needed for planned stenting scenarios.