Cost effectiveness in Canada of eptifibatide treatment for acute coronary syndrome patients using PURSUIT subgroup analysis

Abstract

Objective: To evaluate the cost effectiveness of eptifibatide, a new glycoprotein IIb/IIIa receptor inhibitor, for the treatment of acute coronary syndromes (ACS) in Canada.

Design: A model was created to analyze the cost effectiveness of eptifibatide using outcomes and resource utilization data from the Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) trial, an international, placebo controlled, randomized clinical study evaluating the efficacy of eptifibatide in treating ACS. Cost data were derived from Canadian sources. Clinical outcomes were derived from published survival analyses based on North American PURSUIT data.

Setting: The present analysis is representative of the Canadian health care setting. Data for resource use reflected actual resources used by patients in the Canadian arm of the PURSUIT study.

Patients: Patients included in the PURSUIT study were hospitalized for non-ST segment elevation ACS between November 1995 and January 1997.

Interventions: Eptifibatide or placebo treatment was randomly assigned in addition to standard treatment with acetylsalicylic acid and heparin.

Main results: Per patient costs for hospitalization, medical procedures and medications associated with standard treatment plus placebo were 10,265 dollars compared with 10,691 dollars with eptifibatide, in 1995 Canadian dollars. Eptifibatide patients had lower rehospitalization rates in the six months following treatment. Discounting future health outcomes by 3%, the cost effectiveness of treating ACS patients with eptifibatide in Canada was estimated as 5,165 dollars per year of life gained.

Conclusions: Considering both the cost of eptifibatide therapy over standard treatment and the health benefits associated with it, eptifibatide is a cost effective, economically attractive pharmacological option for the treatment of ACS patients in Canada.