ESTIMATING THE VALUE OF CANGRELOR FROM ELIMINATING PRELOADING IN CORONARY ARTERY BYPASS GRAFT (CABG) PATIENTS
Author(s)
Bay C, Cyr PL, Jensen I
ICON plc, Cambridge, MA, USA
Presentation Documents
OBJECTIVES inhibitor with rapid onset/offset, demonstrated in the CHAMPION PHOENIX trial a reduction in ischemic events vs. clopidogrel in patients undergoing PCI. Adoption of cangrelor for angiography in ACS patients eliminates the need to washout an oral P2Yinhibitor in case of unanticipated CABG. The aim of our analysis was to quantify the annual value of this pathway change to a US hospital. METHODS A decision analytic model based on the current CABG patient pathway was developed to quantify the value of a reduction in bridging by adopting cangrelor from a US hospital perspective. Premier hospital database informed the timing of CABG after washout; demographics, drug-mix, LOS, blood product utilization, and hospital ward costs. Ischemic event rates and costs were informed by published sources. Drug costs were 2014 wholesale acquisition costs. Cangrelor cost was set to $0. RESULTS For a hypothetical US hospital treating 195 CABG patients/year (patient mix: 4% STE-ACS, 26% NSTE-ACS, 70% SA), shifting away from bridging with GPI by adopting cangrelor resulted in a total annual cost reduction of $120,000. Total costs in the base-case are estimated to be $2.95MM vs. the scenario case of $2.83MM. Cost savings were derived from eliminating GPI utilization, lowering washout drug costs and reducing hospitalization days. CONCLUSIONS Removal of the need to washout oral antiplatelet therapy prior to CABG through adoption of cangrelor is estimated to deliver a clinical value of ~$615/CABG patient with fewer total days spent hospitalized.
Conference/Value in Health Info
2014-11, ISPOR Europe 2014, Amsterdam, The Netherlands
Value in Health, Vol. 17, No. 7 (November 2014)
Code
PCV45
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
Cardiovascular Disorders