Economic evaluation of drugs used in treating patients with myocardial infarction: a systematic review

Document Type : Review

Authors

Abstract

AbstractIntroductionMyocardial infarctions (MI) as one of the outcomes of cardiovascular diseases alone are responsible for 20% of deaths, so that every 30 seconds, one person suffered from MI. Various drugs are used to treat myocardial infarction and we need to have precise information of the cost-effectiveness of these drugs. The aim of this study was to examine economic evaluation of drugs used for treatment of patients with MI.   Methods In the present review study, published articles related to economic evaluation of drugs used for treatment of patients with MI within the time interval between 2000 and 2017 were searched using electronic databases. Methodological quality of structure of articles was examined by Drummond’s standard checklist.ResultsThe results of the present study indicated that, a streptokinase and t-PA drug for treatment of patients with myocardial infarction was cost-effective. The results showed that most of the studies clearly stated the time horizon of the study and included direct medical costs in their analysis. In addition, majority of the studies used the Markov model. The quality-adjusted life years (QALYs) were the main outcome used for measuring the effectiveness.ConclusionThe results of the present study showed that, a thrombolytic agent for treatment of patients with myocardial infarction was cost-effective. The results were relatively varied due to the differences in time horizon and variables used in the models such as efficacy, and drug prices. Furthermore these studies were designed and conducted in high-income countries; thus, the application of these results in low- and middle-income countries will be limited.

  1. References:
  2. ....
  3. Kelly BB, Fuster V. Promoting cardiovascular health in the developing world: a critical challenge to achieve global health: National Academies Press; 2010.
  4. Sarrafzadegan N, Sadeghi M, Oveisgharan S, Iranipour R. Incidence of cardiovascular diseases in an Iranian population: the Isfahan Cohort Study. Archives of Iranian medicine. 2013;16(3):138.
  5. Larijani B, Fakhrzadeh H, Mohaghegh M, Pourebrahim R, Akhlaghi M. Burden of coronary heart disease on the Iranian oil industry [1999-2000]. 2003.
  6. Iqbal R, Jahan N, Hanif A. Epidemiology and Management Cost of Myocardial Infarction in North Punjab, Pakistan. Iranian Red Crescent Medical Journal. 2015;17(7).
  7. Keeley EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. The Lancet. 2003;361(9351):13-20.
  8. Members C, Ryan TJ, Anderson JL, Antman EM, Braniff BA, Brooks NH, et al. ACC/AHA guidelines for the management of patients with acute myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction). Journal of the American College of Cardiology. 1996;28(5):1328-419.
  9. Devita C, Fazzini P, Geraci E, Tavazzi L, Tognoni G, Vecchio C, et al. Gissi-3-effects of lisinopril and transdermal glyceryl trinitrate singly and together on 6-week mortality and ventricular-function after acute myocardial-infarction. Lancet. 1994;343(8906):1115-22.
  10. Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes: Oxford university press; 2015.
  11. Rezapour A, Jafari A, Mirmasoudi K, Talebianpour H. Quality Assessment of Published Articles in Iranian Journals Related to Economic Evaluation in Health Care Programs Based on Drummond’s Checklist: A Narrative Review. Iranian Journal of Medical Sciences. 2017;41(2).
  12. Megiddo I, Chatterjee S, Nandi A, Laxminarayan R. Cost-effectiveness of treatment and secondary prevention of acute myocardial infarction in India: a modeling study. Global heart. 2014;9(4):391-8. e3.
  13. Rama M, Miraci M, Balla I, Petrela E, Malaj L, Koleci A. Cost-Effectiveness of Thrombolytic Therapy, Compared with Anticoagulants Therapy in the Treatment of Acute Myocardial Infarction in Albania. Open Access Macedonian Journal of Medical Sciences. 2015;3(2):341.
  14. Wang M, Moran AE, Liu J, Coxson PG, Heidenreich PA, Gu D, et al. Cost-effectiveness of optimal use of acute myocardial infarction treatments and impact on coronary heart disease mortality in China. Circulation: Cardiovascular Quality and Outcomes. 2014:CIRCOUTCOMES. 113.000674.
  15. Marcoff L, Zhang Z, Zhang W, Ewen E, Jurkovitz C, Leguet P, et al. Cost Effectiveness of Enoxaparin in Acute ST-Segment Elevation Myocardial Infarction: The ExTRACT–TIMI 25 (Enoxaparin and Thrombolysis Reperfusion for Acute Myocardial Infarction Treatment–Thrombolysis In Myocardial Infarction 25) Study. Journal of the American College of Cardiology. 2009;54(14):1271-9.
  16. Scuffham PA, Tippett V. The cost-effectiveness of thrombolysis administered by paramedics. Current medical research and opinion. 2008;24(7):2045-58.
  17. Taylor M, Scuffham PA, Chaplin S, Papo NL. An economic evaluation of valsartan for post-MI patients in the UK who are not suitable for treatment with ACE inhibitors. Value in health. 2009;12(4):459-65.
  18. Welsh RC, Sauriol L, Zhang Z, Kolm P, Weintraub WS, Theroux P. Cost-effectiveness of enoxaparin compared with unfractionated heparin in ST elevation myocardial infarction patients undergoing pharmacological reperfusion: A Canadian analysis of the Enoxaparin and Thrombolysis Reperfusion for Acute Myocardial Infarction Treatment–Thrombolysis in Myocardial Infarction (ExTRACT-TIMI) 25 trial. Canadian Journal of Cardiology. 2009;25(12):e399-e405.
  19. Araújo DV, Tura BR, Brasileiro AL, Luz Neto H, Pavão ALB, Teich V. Cost-effectiveness of prehospital versus inhospital thrombolysis in acute myocardial infarction. Arquivos brasileiros de cardiologia. 2008;90(2):100-7.
  20. Choudhry NK, Patrick AR, Antman EM, Avorn J, Shrank WH. Cost-effectiveness of providing full drug coverage to increase medication adherence in post–myocardial infarction Medicare beneficiaries. Circulation. 2008;117(10):1261-8.
  21. Kent DM, Vijan S, Hayward RA, Griffith JL, Beshansky JR, Selker HP. Tissue plasminogen activator was cost-effective compared to streptokinase in only selected patients with acute myocardial infarction. Journal of clinical epidemiology. 2004;57(8):843-52.
  22. Maniadakis N, Kaitelidou D, Siskou O, Spinthouri M, Liaropoulos L, Fragoulakis B, et al. Economic evaluation of treatment strategies for patients suffering acute myocardial infarction in Greece. Hellenic J Cardiol. 2005;46(3):212-21.
  23. Vale L, Steffens H, Donaldson C. The Costs and Benefits of Community Thrombolysis for Acute Myocardial Infarction. Pharmacoeconomics. 2004;22(14):943-54.
  24. Xin S. Markov modelling in healthcare economic evaluations. Chin J Evid-based Med. 2007;7(10):750-6.
  25. Sun X, Faunce T. Decision-analytical modelling in health-care economic evaluations. The European Journal of Health Economics. 2008;9(4):313-23.
  26. Andronis L, Barton P, Bryan S. Sensitivity analysis in economic evaluation: an audit of NICE current practice and a review of its use and value in decision-making: Prepress Projects; 2009.
  27. Bojke L, Claxton K, Sculpher M, Palmer S. Characterizing structural uncertainty in decision analytic models: a review and application of methods. Value in Health. 2009;12(5):739-49.
  28. Briggs AH, Ades A, Price MJ. Probabilistic sensitivity analysis for decision trees with multiple branches: use of the Dirichlet distribution in a Bayesian framework. Medical Decision Making. 2003;23(4):341-50.
  29. Briggs AH, Goeree R, Blackhouse G, O’Brien BJ. Probabilistic analysis of cost-effectiveness models: choosing between treatment strategies for gastroesophageal reflux disease. Medical decision making. 2002;22(4):290-308.
  30. Hutubessy R, Chisholm D, Edejer TT-T. Generalized cost-effectiveness analysis for national-level priority-setting in the health sector. Cost effectiveness and resource allocation. 2003;1(1):8.