Cost-effectiveness of thrombolytics: a simplified model.
OBJECTIVE
To construct a simple model for an internal, retrospective cost-effectiveness analysis and to calculate the incremental cost-effectiveness of tissue plasminogen activator (TPA) over streptokinase (SK) in Turkey.


METHODS
Koşuyolu Heart, Education and Research Hospital, Istanbul, Turkey.


METHODS
Among patients who were hospitalized for treatment of acute myocardial infarction (AMI), 196 were randomly selected. One-year mortality rates according to the treatment groups (TPA, SK, other) were determined. Among surviving patients, 28 from TPA and another 28 from SK group were randomly selected for the pharmacoeconomic analysis. Patient treatment data were taken from medical records while data regarding to costs were taken from hospital bills.


METHODS
Incremental cost-effectiveness ratio (ICER). The cost part of the ratio was considered as 'the overall-costs', while the effectiveness part was considered as 'lives saved' per treatment group.


RESULTS
With an increased one-year survival rate of 2.37% and an increased cost of euro 1120.8 ($1165.6) per patient in the TPA group, the ICER for the use of TPA instead of SK was euro 47,289 ($49,180.6) per life saved.


CONCLUSIONS
This model can be a guide for similar analyses. The results of our study (the incremental cost-effectiveness of TPA over SK) will be informative for the decision-makers in Turkey, by whom the medical benefit for money spent would be assessed and judged. We believe that our results make a contribution to similar studies in the literature.
Apikoğlu Rabuş
Sule
S
Clinical Pharmacy Department, Faculty of Pharmacy, Marmara University, Tibbiye Cad. no 49, Haydarpasa, 34817, Istanbul, Turkey.
Izzettin
Fikret Vehbi
FV
Sancar
Mesut
M
Rabuş
Murat Bülent
MB
Kirma
Cevat
C
Yakut
Cevat
C
D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D003663:Decision Trees; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D015233:Models, Statistical; D010960:Plasminogen Activators / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D012189:Retrospective Studies; D013300:Streptokinase / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D016019:Survival Analysis; D013927:Thrombosis / Q000188:drug therapy / Q000191:economics / Q000401:mortality; D010959:Tissue Plasminogen Activator / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use
D005343:Fibrinolytic Agents; D013300:Streptokinase; D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator