A practical cost analysis of bivalirudin.
Despite advances in percutaneous coronary intervention (PCI) techniques and adjunctive therapies, the risks of ischemic and bleeding complications with PCI remain significant. These complications are associated with significant morbidity and mortality, as well as substantially higher costs. Bivalirudin is the only antithrombotic agent that has been shown to reduce both ischemic and hemorrhagic complications associated with PCI. Cost models drawn from the results of three clinical trials of bivalirudin have estimated its potential impact on total medical costs. In addition, the number needed to treat to avoid a bleeding complication has been calculated based on patients shown to have a heightened risk of bleeding in the Bivalirudin Angioplasty Trial. In all models assessed, the use of bivalirudin offset most of its own cost through reductions in bleeding and ischemic complications.
Compton
Anthony
A
Saint Joseph's Hospital of Atlanta, Georgia 30342, USA. acompton@sjha.org
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000191:economics*; D000925:Anticoagulants / Q000008:administration & dosage / Q000191:economics*; D001803:Blood Transfusion / Q000191:economics; D003365:Costs and Cost Analysis; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000191:economics*; D006493:Heparin / Q000191:economics; D006629:Hirudins / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000191:economics*; D006801:Humans; D009203:Myocardial Infarction / Q000191:economics / Q000209:etiology / Q000517:prevention & control; D010446:Peptide Fragments / Q000008:administration & dosage / Q000191:economics*; D016032:Randomized Controlled Trials as Topic / Q000191:economics; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000191:economics*; D051437:Renal Insufficiency / Q000150:complications / Q000378:metabolism; D012086:Reoperation / Q000191:economics
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D006629:Hirudins; D010446:Peptide Fragments; D011994:Recombinant Proteins; D006493:Heparin; C074619:bivalirudin