Cost effectiveness of abciximab during routine medical practice
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Updated: Oct 9, 2026
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Published on: February 5, 2021
S O Reed1, C D Mullins, L S Magder
1Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, Washington, USA. sdreed@u.washington.edu
Insights
Abciximab use in high-risk patients undergoing coronary revascularization showed a 40% reduction in ischemic events. However, this treatment was associated with higher costs at six months, indicating a complex cost-effectiveness profile.
Area of Science:
- Cardiovascular Medicine
- Health Economics
- Interventional Cardiology
Background:
- Coronary revascularization procedures carry risks of ischemic events.
- Abciximab is a glycoprotein IIb/IIIa inhibitor used to reduce thrombotic complications.
- Assessing the cost-effectiveness of adjunctive therapies is crucial for healthcare resource allocation.
Purpose of the Study:
- To estimate the cost per ischemic event avoided at 6 months in high-risk patients undergoing coronary revascularization treated with abciximab.
- To evaluate the economic impact of abciximab in routine medical care settings.
Main Methods:
- Retrospective, matched cohort study design.
- Inclusion of 62 abciximab-treated patients and 62 matched controls with high-risk coronary lesions.
- Calculation of the incremental cost-effectiveness ratio (ICER) from a third-party payer perspective over 6 months.
Main Results:
- Abciximab-treated patients had a 40% lower rate of ischemic events (16.1% vs. 27.4%, p=0.128) at 6 months.
- The point estimate for the ICER was $US21,789 per ischemic event avoided.
- Statistical analysis indicated wide confidence intervals for the ICER, suggesting uncertainty in the cost-effectiveness.
Conclusions:
- Abciximab demonstrated effectiveness in reducing ischemic events in high-risk patients, consistent with clinical trial findings.
- Despite reduced events, abciximab-treated patients incurred higher costs (approximately $US2400) at 6 months.
- The cost-effectiveness of abciximab in this setting requires careful consideration due to the observed cost increase and statistical uncertainty.
Objective:
To estimate the cost per ischaemic event (death, nonfatal myocardial infarction, subsequent revascularisation procedure) avoided at 6 months in high risk patients undergoing coronary revascularisation treated with abciximab during routine medical care.
Design:
Retrospective, matched cohort design.
Setting:
University teaching hospital.
Patients:
62 abciximab-treated patients and 62 patients not treated with abciximab with high risk coronary lesions were matched according to gender, hyperlipidaemia, diabetes mellitus and stenting.
Main Outcome Measures:
Using a third-party payer's perspective, an incremental cost-effectiveness ratio (ICER) was computed as the cost per ischaemic event avoided over 6 months. Fieller's theorem was used to estimate confidence sets and confidence ellipses were generated to visually represent the variability in the data.
Results:
At 6 months, abciximab-treated patients experienced an approximately 40% lower rate of ischaemic events (16.1 vs 27.4%; p = 0.128). The point estimate of the ICER was $US21,789 per ischaemic event avoided. Fieller's theorem resulted in a 95% confidence set consisting of 2 half-lines (-infinity to -$US115,461) and ($US391 to +infinity), reflecting the finding that the ICER denominator was not significantly different from zero at the p = 0.05 level.
Conclusions:
In high risk patients treated during routine care, the effectiveness of abciximab was consistent with efficacy rates from clinical trials. However, abciximab-treated patients remained approximately $US2400 more costly at 6 months.
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