Pharmacoeconomic Data From GUSTO Supports tPA

Thrombolysis in acute myocardial infarction patients using Genentech's tissue plasminogen activator product Activase (alteplase) costs more than using streptokinase, but achieves a higher patient survival rate at one year, according to the results of the GUSTO study (Marketletters passim).

In the latest analysis of the GUSTO data, a pharmacoeconomic study published in the New England Journal of Medicine (May 25) suggests that Activase given in an accelerated (1.5 hour) regimen is cost-effective, and that this cost-effectiveness "compares favorably with that of other therapies whose added medical benefit is judged by society to be worthwhile."

One year after enrollment into GUSTO, patients who received Activase had both higher costs ($2,845) and a higher survival rate (an increase of 1.1%) than streptokinase-treated patients, say the authors of the study. On the basis of the projected life expectancy of each treatment group, the incremental cost-effectiveness ratio was $32,678 per year of life saved. The use of Activase was least cost-effective in younger patients and most cost-effective in older patients, they continue.