Cost-Effectiveness of Targeting Patients Undergoing Percutaneous Coronary Intervention for Therapy With Bivalirudin Versus Heparin Monotherapy According to Predicted Risk of Bleeding
Key result
Substituting bivalirudin for unfractionated heparin monotherapy in PCI patients is projected to increase costs by $571 per patient, yielding $1,173,360 per quality-adjusted life-year gained.
Why the study?
Is bivalirudin cost-effective compared to unfractionated heparin monotherapy in patients undergoing PCI?
Population
n=81,628 patients from the National Cardiovascular Data Registry CathPCI Registry undergoing percutaneous…
Comparison
Bivalirudin vs Unfractionated heparin monotherapy
Design
Other
Authors
Discussion
Loading...
Member takes
Implication
Bivalirudin not cost-effective versus heparin in routine PCI; leaves open targeted evaluation in high-bleeding-risk subgroups.
Structured PICO
Is bivalirudin cost-effective compared to unfractionated heparin monotherapy in patients undergoing PCI?
P
Population
81,628 patients from the NCDR CathPCI Registry undergoing percutaneous coronary intervention who received unfractionated heparin only.
I
Intervention
Bivalirudin
C
Comparator
Unfractionated heparin monotherapy
O
Outcome
Cost-effectiveness (cost per bleeding event averted and cost per quality-adjusted life-year gained)
Main Result
Effect estimate: $1,173,360 per QALY gained
Bivalirudin is not cost-effective for all-comers undergoing PCI compared to heparin monotherapy, but may be cost-effective in a small subset of patients with high predicted bleeding risk.
Cite This Study
Amin et al. (2010) studied Percutaneous coronary intervention (n=81,628). Bivalirudin vs. Unfractionated heparin monotherapy was evaluated on Cost-effectiveness (cost per quality-adjusted life-year gained) ($1,173,360 per QALY gained). Substituting bivalirudin for unfractionated heparin monotherapy in PCI patients is projected to increase costs by $571 per patient, yielding $1,173,360 per quality-adjusted life-year gained.