Acute coronary syndrome: eptifibatide was cost-effective for patients without ST elevation.

Clinical bottom line (level 1b)

  1. Eptifibatide was a cost-effective treatment for patients with non-ST elevation acute coronary syndromes.
Mark et al: Circulation 2000; 101 : 366-371
Expires October 2003

The study

cost-effectiveness and cost-utility analysis
Setting: 726 hospitals in 28 countries

Data taken from PURSUIT trial involving 10948 patients.
  • Viewpoint: societal (nonmedical costs, outpatient care and productivity costs were omitted)
  • Benefit assessment: 1 extra life-year; death plus nonfatal myocardial infarction
  • Resources and costs: medical resource use and costs in 1996 US dollars associated with hospitalisation and for the following 6 months, including hospital costs, physician fees, cost of eptifibatide. Discounting was performed at 3% per annum. Patient utilities were derived from a PURSUIT questionnaire administered to 1978 US patients.
  • Sensitivity analysis: The following variables were adjusted in a sensitivity analysis: prognosis of nonfatal MIs, definition of MI, size of 30-day benefit from treatment

The evidence

intervention cost
cost-effectiveness ratio of eptifibatide v. placebo per year of life saved $16491
cost-utlity ratio of eptifibatide v. placebo per quality-adjusted life-year $19693

Effect of sensitivity analysis: Costs ranged from $10954 to $25460

Comments

 

  1. The cost-effectiveness range noted corresponds with other treatments already available (e.g. thrombolysis for myocardial infarction, renal dialysis).

Citation

 

  1. Mark DB, Harringtno RA, Lincoff M, et al: cost-effectiveness of platelet glycoprotein IIb/IIIa inhibition with eptifibatide in patients with non-ST elevation acute coronary syndromes. Circulation 2000; 101 : 366-371
Search Terms: from other articles noted in ACP Journal Club
Contributor: Chris Ball, October 2001
Reviewer:

Clinical Question.
Patient non-ST elevation acute coronary syndrome
Intervention or Exposure eptifibatide compared with placebo
Outcome cost-effectiveness