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Updated: Jul 25, 2026
05:52
Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
Using efficacy, safety, and cost data to support a formulary decision regarding thrombolytic therapy
1Department of Pharmacy, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Seminars in Vascular Surgery
|June 16, 2001
Summary
Alteplase is a more cost-effective thrombolytic for peripheral vascular disease (PVD) than reteplase. Both treatments show similar efficacy and safety, but alteplase offers significant cost savings.
Area of Science:
- Pharmacology
- Vascular Medicine
- Health Economics
Background:
- Urokinase withdrawal necessitated evaluation of alternative thrombolytics for peripheral vascular disease (PVD).
- Alteplase and reteplase emerged as potential replacements.
- Clinical data comparing their efficacy and safety were lacking.
Purpose of the Study:
- To compare the efficacy, safety, and cost-effectiveness of alteplase and reteplase for PVD treatment.
- To inform clinical decision-making and formulary recommendations.
Main Methods:
- Formal evaluation by the Department of Pharmacy.
- Presentation to the Pharmacy and Therapeutics Committee.
- Cost analysis comparing total cost of care for both agents.
Main Results:
- No published data indicated differences in efficacy or safety between alteplase and reteplase.
- Average total cost of care was significantly higher for reteplase ($4,556) versus alteplase ($2,139).
Conclusions:
- Alteplase is a more cost-effective thrombolytic agent for treating PVD.
- Clinical guidelines should consider cost-effectiveness alongside efficacy and safety.
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