Prospective Pharmacoeconomic Surveillance Of Therapeutic Interventions For Coronary Thrombosis In Cardiac Patients Admitted To Tertiary Care Hospital

Abstract

newline Background Economics has been implied with each of the monitory transactions in life including those related to healthcare issues (health economics). Health economics helps to create an environment to analyze the supply of goods and services and provides cost effective solution from comparison of alternative healthcare programs. Pharmacoeconomic evaluation supports rationalization of therapeutic approaches and helps in identifying the best. Pharmacoeconomic studies in relevance to coronary heart disease are lacking in developing countries like India. Therefore, the present study was planned to evaluate cost effectiveness of therapeutic interventions in coronary thrombosis. Objectives To carry out pharmacoeconomic evaluation of various therapeutic interventions such as thrombolysis with streptokinase or tenecteplase and mechanical (primary PTCA, late PTCA and CABG) for the treatment of acute coronary syndrome due to coronary thrombosis. Methodology The present study was carried out for a period of two years at KLES Dr Prabhakar Kore Hospital and Medical Research Center, Belgaum (Karnataka). All the patients with established diagnosis of coronary thrombosis were recruited into the study. Patients were monitored from the day of admission till the day of discharge during clinical rounds with the respective consultant cardiologist(s) daily, to assess the prognosis. Clinical outcome (in terms of recovery, restenosis or re-infarction) was assessed at the time of discharge and subsequent follow-up visits. The costs including direct, indirect, cost of ADEs was estimated and mean cost per life saved was calculated based on available data. Results A total of 206 patients who consented for the study were enrolled. The recovery rate was observed to be significantly (p= 0.006) higher in streptokinase (STK) group (75.53%) as compared to that of tenecteplase (TNK) group (52.27%). Analysis of cost (direct as well as indirect) revealed that the hospital cost in STK group was observed to be high [ 88,17,859.36 (8.8m)]