Cost-Effectiveness of Recombinant HumanTNK Tissue-Type Plasminogen Activator(Rhtnk-Tpa) Versus Recombinant TissuePlasminogen Activator (Rt-PA) in Treating STElevationMyocardial Infarction (STEMI)

Abstract

Objective: While the clinical effect of rhTNK-tPA in STEMI treatment has been established, the economic effect of adopting the new therapy (rh-TNK-tPA) is still unclear. The present study aimed to examine the cost-effectiveness of rhTNK-tPA compared with rt-PA in the Chinese setting. Methods: A Markov model was constructed to conduct the cost-effectiveness analysis from a third-party payer perspective. Costs of PCI, rehabilitation after discharge, CABG, myocardial ischemia recurrence, cardiac shock, reinfarction, and adverse events were considered. Clinical effectiveness data were obtained from the pivotal phase II clinical trial. Sensitivity analyses were conducted to examine the robustness of the base-case findings. Results: The total cost of treatment for the 30 days after STEMI onset in the rhTNK-tPA and rt-PA arms were ¥30,846 and ¥31,314, respectively. The QALYs of rhTNK-tPA and rt- PA arms were 0.0345 and 0.0343 respectively. RhTNK-tPA was dominant. The total cost of lifetime in the rhTNK-tPA and rt-PA arms were ¥134,519 and ¥134,311, respectively. The corresponding QALYs in the rhTNK-tPA and rt-PA arms were 6.397 and 6.356, respectively. The ICER of rhTNK-tPA vs. rt-PA treatment was ¥5,020/QALY. The sensitivity analyses showed that rhTNK-tPA was dominant in most scenarios. Conclusions: RhTNK-tPA therapy is cost-saving and more effective compared with rt-PA for STEMI treatment in the Chinese population.