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. The aim of this cost consequence analysis was to estimate the economics and consequences of varying clevidipine utilization for BP management in patients undergoing cardiac surgery.

METHODS: A decision analytic model was developed to simulate the costs and consequences associated with the use of clevidipine, sodium nitroprusside, and nicardipine in patients undergoing cardiac surgery experiencing hypertension. Outcomes were quantified from a US hospital perspective over a 3-year time horizon. The utilization of IV-antihypertensives was calculated using 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 cardiac surgery claims. A change in utilization was modelled from the low adopter profile with a linear increase over 3 years to the high adopter profile. The infusion rates were based on customer survey data on file. Drug-costs were based on wholesale acquisition cost from ProspectoRx. Clinical, dosing, hospital and health resource costs were based on literature. Costs were adjusted to 2022USD.

RESULTS: For a hypothetical caseload of 100 cardiac surgery patients, the increased use of clevidipine reduces the IV-antihypertensive average infusion volume by 242 mL/patient. The average hospital costs were slightly lowered resulting in an average cost saving of $35/patient. Additionally, increased use of clevidipine led to reductions in the average length of stay (i.e., ICU, OR, and general ward) by 63 days in total, which resulted in an average cost saving of $15,697.

CONCLUSIONS: The increased use of clevidipine in cardiac surgery patients results in improved outcomes and cost savings over the 3 years, especially due to a reduction in total hospital stay.