[Costs and cost-effectiveness of Eptifibatide in the treatment of coronary ischemic syndromes. An analysis based on the PURSUIT study].
OBJECTIVE
We analyzed whether using Eptifibatide plus heparin compared to heparin alone in patients with acute coronary ischemic syndromes is cost saving and/or cost-effective from the perspective of German hospitals. Our analysis is based on the clinical results of the PURSUIT study.


METHODS
We conducted an incremental cost-consequence and cost-effectiveness analysis from the perspective of the admitting hospital. Costs refer to the initial hospitalization following the event. Incremental drug costs are based on a 72 hour infusion of Eptifibatide. Additional costs are analyzed as resulting from the management of complicating myocardial infarctions, including incremental days on the general ward or intensive care unit as well as necessary revascularization procedures. All costs are expressed in EURO (EUR). The estimated costs of managing ischemic complications are based on typical patterns seen in German hospitals. Our estimation of the life-years saved by using Eptifibatide is based on the DEALE method. All calculations are standardized to a hypothetical cohort of 100 treated patients.


RESULTS
There are 0.064 saved life-years per patient. Cost-effectiveness of Eptifibatide is EUR 14,464 per life-year saved.


CONCLUSIONS
Eptifibatide is cost-effective compared to other therapies in the treatment of acute coronary ischemic syndromes. The additional costs of using this substance should be reimbursed to the hospitals.
Szucs
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TD
Hirslanden Research, Seefeldstrasse 214, 8008 Zürich, Switzerland. thomas.szucs@hirslanden.ch
Schwenkglenks
M
M
Berger
K
K
Karsch
K
K
D000789:Angina, Unstable / Q000188:drug therapy* / Q000191:economics / Q000601:surgery / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D015331:Cohort Studies; D016001:Confidence Intervals; D001026:Coronary Artery Bypass; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D000077542:Eptifibatide; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D015337:Multicenter Studies as Topic; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000191:economics / Q000601:surgery / Q000628:therapy; D010455:Peptides / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010455:Peptides; D010975:Platelet Aggregation Inhibitors; D006493:Heparin; D000077542:Eptifibatide