USING NATIONAL AND INSTITUTIONAL ECONOMIC DATA TO TARGET MOST COST-EFFECTIVE USE OF ABCIXIMAB

Medicare data was used along with institution-specific information and . published criteria from a major clinical trial to identify the best health economic investment for use of an expensive pharmaceutical. The first step was to determine which percutaneous transluminal coronary angioplasty (PTCA) patients were the highest users of resources. High- risk criteria as defined by the EPIC trial investigators, Medicare sta tistics and costs, and concomitant diagnoses as revealed by national a nd institutional billing information were compiled, Analysis of the da ta showed that patients with acute MI and those with diabetes mellitus with complications incurred the largest deficit between reimbursement and the cost of treating the complications associated with PTCA. Base d on the greater relative efficacy of abciximab therapy in acute MI an d unstable angina and the cost reimbursement differences seen in acute MI and diabetes with complications, more cost-effective abciximab use can occur by targeting these populations.