OBJECTIVES: Clevidipine is an intravenous (IV) dihydropyridine calcium channel blocker indicated for the reduction of blood pressure (BP) when oral therapy is not feasible or not desirable in US. The aim of the cost consequence analysis was to estimate the economics and consequences of varying clevidipine utilization in patients with acute hypertension (aHTN).

METHODS: A decision analytic model was developed to simulate the costs and consequences associated with the use of clevidipine, labetalol, and nicardipine in patients with severe aHTN in the emergency room or critical care setting. The outcomes were quantified from a US hospital perspective over a 3-year time horizon. The utilization of IV-antihypertensives was calculated by a combination of purchase history and Diagnosis Related Group (DRG) claims. Low and high clevidipine adopter profiles were formed using a retrospective analysis of IV-antihypertensive purchases in hospitals above the median of aHTN-claims. A change in utilization was modelled from the low adopter profile with a linear increase over 3 years to the high adopter profile. Infusion rates were based on customer survey data on file. Drug costs were based on wholesale acquisition cost from ProspectoRx. Clinical inputs, and dosing information were based on literature.

RESULTS: For a hypothetical caseload of 100 patients with aHTN, the use of clevidipine over 24 hours resulted in 2 more patients reaching BP target in 30 minutes and the average time to reach BP target was 7.2 min faster. Additionally, there were 27 fewer cases of concomitant or subsequent IV-antihypertensive use. The average primary drug infusion volume was reduced by 549 mL per patient. The average drug costs decreased by $84/patient.

CONCLUSIONS: The increased use of clevidipine in patients with aHTN results in more patients reaching BP target in less time with a decrease in the cost over the 3 years.