Impact Of The New Cholesterol Guidelines In A Managed Care Setting

Abstract

thetical cohort of 1,000 PCI patients/year (STEMI= 6.4%, NSTEMI/UA= 16.7%, stable angina= 76.9%) treated with heparin+/-GPI (weighted average of 30.0% GPI use across diagnoses), use of bivalirudin+cangrelor+2.8% GPI provided a hospital $0.95MM in clinical value. Cost-offsets were derived from a reduction in GPI use, lower ischemic and bleeding events. Sensitivity was assessed in using heparin+/-GPI; GPI%= 70.6% (extreme from APEX-AMI trial) vs. bivalirudin+cangrelor+9.7% GPI where the clinical value was estimated at $1.59MM. ConClusions: Use of bivalidudin+cangrelor during PCI delivers an estimated clinical value of at least $950 per PCI-patient, $1,590 in STEMI patients with improved clinical outcomes.