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Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
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Potential economic consequences of a cardioprotective agent for patients with myocardial infarction: modelling study

Talitha I Verhoef1, Stephen Morris1, Anthony Mathur2

  • 1Department of Applied Health Research, University College London, London, UK.

BMJ Open
|November 15, 2015
PubMed

Insights

A new cardioprotective agent could be cost-effective for reducing heart failure and mortality after percutaneous coronary intervention (PCI). Its cost-effectiveness depends on the agent

Area of Science:

  • Cardiovascular Medicine
  • Health Economics
  • Interventional Cardiology

Background:

  • Anterior ST-elevation myocardial infarction (STEMI) often requires percutaneous coronary intervention (PCI).
  • Reducing infarct size and subsequent heart failure (HF) post-PCI is a clinical priority.
  • The cost-effectiveness of cardioprotective agents for STEMI patients undergoing PCI is not fully established.

Purpose of the Study:

  • To evaluate the cost-effectiveness of a hypothetical cardioprotective agent for reducing infarct size in STEMI patients undergoing PCI.
  • To assess the potential impact of such an agent on heart failure and mortality rates.
  • To determine the incremental cost-utility ratio (ICUR) per quality-adjusted life-year (QALY) gained.

Main Methods:

  • A cost-utility analysis was performed using a Markov model.
  • The analysis was set within the UK National Health Service.
  • Simulations considered a cardioprotective agent administered during reperfusion versus no intervention, with varying costs (£1000-4000).

Main Results:

  • Incremental costs ranged from £933 to £3820, with incremental QALYs from 0.04 to 0.38.
  • The incremental cost-effectiveness ratio (ICER) varied widely, from £3311 to £63,480 per QALY gained.
  • Cost-effectiveness was sensitive to agent cost, patient age, and HF risk reduction; 71% of simulations fell below the £20,000/QALY threshold.

Conclusions:

  • A cardioprotective agent reducing HF and mortality post-PCI shows high potential for cost-effectiveness.
  • The economic viability is contingent upon the agent's price, patient demographics, and its efficacy in mitigating HF risk.
  • Further economic evaluations are warranted based on specific agent characteristics and target populations.
Abstract

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