August 15, 1996Circulation
Economic Assessment of Platelet Glycoprotein IIb/IIIa Inhibition for Prevention of Ischemic Complications of High-Risk Coronary Angioplasty
Key result
c7E3 Fab reduces 6-month repeat hospitalization ~23% after high-risk coronary angioplasty.
- P=0.42
- n=2,038
Why the study?
Does c7E3 Fab reduce medical costs and resource utilization in patients undergoing high-risk coronary angioplasty?
Population
2038 patients undergoing high-risk coronary angioplasty (from the EPIC trial)
Comparison
c7E3 Fab bolus and infusion vs Placebo (standard care)
Design
Other, randomized
Follow-up
6 months
Authors
Discussion
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Member takes
Implication
Offsets most drug costs in high-risk angioplasty; extends EPIC ischemic benefits to resource utilization.
Key Points
- This research aims to evaluate the economic impact of platelet glycoprotein IIb/IIIa inhibition during high-risk coronary angioplasty.
- Analyzed data from 2038 out of 2099 patients in the EPIC trial for cost and resources.
- Used regression analysis to assess economic tradeoffs between ischemic events and bleeding.
- Compared hospital costs and outcomes between c7E3 Fab and placebo groups.
- 30-day ischemic events reduced by 35% with c7E3 Fab (P=0.004).
- Increased in-hospital bleeding costs averaged $521 per patient, offsetting initial savings of $622 from reduced ischemic events.
- Net savings of $1270 per patient over 6 months with c7E3 Fab compared to standard care (P=0.018).
Study Design
Type
RCT (n=2,038)
Randomization
Randomized
Structured PICO
Does c7E3 Fab reduce medical costs and resource utilization in patients undergoing high-risk coronary angioplasty?
P
Population
2038 patients undergoing high-risk coronary angioplasty (from the EPIC trial)
I
Intervention
c7E3 Fab (antiplatelet IIb/IIIa receptor antibody) bolus and infusion
C
Comparator
Placebo (standard care)
O
Outcome
Prospective hospital cost and major resources during initial hospitalization and 6-month follow-up
Main Result
Absolute Event Rate: 13577% vs 13434%
p-value: p=0.42
In high-risk coronary angioplasty, c7E3 Fab significantly reduces ischemic events and repeat revascularization, recouping most of its drug cost over 6 months.
Cite This Study
Mark et al. (1996) conducted an RCT in High-risk coronary angioplasty (n=2,038). c7E3 Fab vs. Placebo was evaluated on Baseline medical costs during initial hospitalization (exclusive of drug cost) (p=0.42). Aggressive platelet inhibition with c7E3 Fab during high-risk coronary angioplasty reduced 6-month repeat hospitalization by 23% (P=0.004), resulting in a cumulative net cost of $293 per patient.