[An economic evaluation of low dose recombinant human tissue-type plasminogen activator for the treatment of acute pulmonary thromboembolism].
OBJECTIVE
To compare and evaluate the cost and effectiveness between recombinant human tissue-type plasminogen activator (rt-PA) 50 mg and 100 mg regimen for the treatment acute pulmonary thromboembolism (PTE).


METHODS
Based on a randomized clinical trial data, 118 cases were enrolled, 65 cases in group 50 mg and 53 cases in group 100 mg, which showed the similar efficacy and safety of rt-PA 50 mg and 100 mg. Progressive improvement in pulmonary artery obstructions was found to be similarly significant in both treatment groups, but there was no significant differences between the two groups (89.1% vs 89.6%, chi(2) = 0.007, P = 0.936). The rates of adverse events in two groups were same as well (17% vs 32%, chi(2) = 3.704, P = 0.054). We compared the cost directly and the cost-effective rate of the two groups. Based the cost saving of individual patient, prevalence rate of acute PTE, and co-pay rate of reimbursement, we calculated the cost saving of societal and payer's perspective.


RESULTS
The cost of group 50 mg is 6352 RMB/person, and the cost of group 100 mg is 12,704 RMB/person. The cost-effect rates of the two groups were 7129 and 14,179 separately. With the same effect, each patient in 50 mg group can save 7050 RMB. If the PTE patients in China were treated with rt-PA 50 mg instead of 100 mg, the society cost saving would be 443,604,624 RMB.


CONCLUSIONS
rt-PA 50 mg/2 h regimen, compared with 100 mg/2 h, can not only provide similar efficacy and safety, but also show a good health economic saving.
Wu
Yi-qun
YQ
Key Laboratory of Epidemiology of Peking University, Ministry of Education, School of Public Health, Peking University, Beijing 100191, China.
Tao
Li-bo
LB
Lü
Cong
C
Hu
Yong-hua
YH
D000293:Adolescent; D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D015912:Thrombolytic Therapy / Q000191:economics*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D055815:Young Adult
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator