PMID- 18473867
OWN - NLM
STAT- MEDLINE
DCOM- 20080716
LR  - 20190728
IS  - 1873-4286 (Electronic)
IS  - 1381-6128 (Linking)
VI  - 14
IP  - 12
DP  - 2008
TI  - Pharmacoeconomics of anticoagulants in acute coronary syndrome and percutaneous 
      coronary intervention.
PG  - 1197-204
AB  - Economic evaluation plays an important role during almost all stages of 
      pharmaceutical design and use. This paper reviews the recent pharmacoeconomic 
      literature on the use of anticoagulants for acute coronary syndromes (ACS) and 
      percutaneous coronary intervention (PCI). Both ACS and PCI are common reasons for 
      hospitalization and contribute significantly to costs of care. ACS and PCI 
      practice standards are still evolving. For ACS enoxaparin does appear to be more 
      cost-effective around the globe than unfractionated heparin (UFH) when 
      clopidrogel and glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors are not used. With 
      the high prevalence of clopidrogel and GP IIb/IIIa use, the question may be moot. 
      Since the cost of UFH therapy, including the cost of anticoagulant monitoring, is 
      less expensive than enoxaparin therapy, UFH is probably the more cost-effective 
      strategy. For PCI, as ischemic complications were reduced during the mid'90's, 
      bleeding complications have become the most common problem and a major cost 
      driver. Other complications that can drive costs include the occurrence of MI and 
      revascularization procedures (repeat PCI or CABG). Results suggest that 
      bivalirudin plus a provisional GP IIb/IIIa inhibitor is the most cost-effective 
      strategy for patients undergoing elective PCI. There is no clear evidence 
      regarding its use in urgent PCI. ACS and PCI practice standards are still 
      evolving. It would be useful to embed economic studies within new clinical 
      trials. Full economic analysis of groups at high risk for bleeding while 
      undergoing PCI is needed.
FAU - Huston, S A
AU  - Huston SA
AD  - Clinical and Administrative Pharmacy, College of Pharmacy, University of Georgia, 
      GA, USA. shuston@rx.uga.edu
FAU - Hawkins, D
AU  - Hawkins D
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United Arab Emirates
TA  - Curr Pharm Des
JT  - Current pharmaceutical design
JID - 9602487
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 0 (Hirudins)
RN  - 0 (Peptide Fragments)
RN  - 0 (Platelet Glycoprotein GPIIb-IIIa Complex)
RN  - 0 (Recombinant Proteins)
RN  - 9005-49-6 (Heparin)
RN  - TN9BEX005G (bivalirudin)
SB  - IM
MH  - Acute Coronary Syndrome/drug therapy/*economics
MH  - Angina, Unstable/economics/therapy
MH  - Angioplasty, Balloon, Coronary/*economics
MH  - Anticoagulants/*economics/therapeutic use
MH  - Cost-Benefit Analysis
MH  - Drug Costs
MH  - Heparin/economics/therapeutic use
MH  - Heparin, Low-Molecular-Weight/economics/therapeutic use
MH  - Hirudins/economics
MH  - Humans
MH  - Myocardial Infarction/economics/therapy
MH  - Peptide Fragments/economics/therapeutic use
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/antagonists & inhibitors
MH  - Recombinant Proteins/economics/therapeutic use
MH  - Stents
RF  - 42
EDAT- 2008/05/14 09:00
MHDA- 2008/07/17 09:00
CRDT- 2008/05/14 09:00
PHST- 2008/05/14 09:00 [pubmed]
PHST- 2008/07/17 09:00 [medline]
PHST- 2008/05/14 09:00 [entrez]
AID - 10.2174/138161208784246162 [doi]
PST - ppublish
SO  - Curr Pharm Des. 2008;14(12):1197-204. doi: 10.2174/138161208784246162.