Cost-utility analysis of thrombolytic therapy

Area of Science:

• Cardiology
• Health Economics

Background:

• Thrombolytic therapy is a crucial treatment for acute myocardial infarction.
• Assessing the long-term cost-effectiveness of thrombolysis is essential for clinical and economic decision-making.

Purpose of the Study:

• To analyze the 3- to 5-year cost-effectiveness of intracoronary streptokinase compared to conventional therapy.
• To evaluate the impact of thrombolytic therapy on mortality, life years gained, and healthcare costs.

Main Methods:

• A randomized analysis of 533 patients comparing conventional therapy with intracoronary streptokinase.
• Follow-up data collected over 3 to 5 years, including mortality, costs, and quality of life adjustments.
• Economic evaluation using discounted future costs and quality-adjusted life years.

Main Results:

• Thrombolytic therapy reduced 3-year mortality from 22% to 14%.
• Average gain in life years was 3.4 years, with higher gains for anterior (5.1 years) versus inferior (1.6 years) wall infarction.
• Additional lifetime costs per life year gained were favorable (ECU 2940 overall), comparing well with other cardiovascular therapies.

Conclusions:

• Intracoronary streptokinase is a highly cost-effective intervention for myocardial infarction.
• The economic benefits justify wider application, irrespective of economic constraints.
• Thrombolytic therapy does not significantly increase the need for subsequent procedures like bypass surgery or PTCA.