Using decision analysis to evaluate the cost effectiveness of GP IIb/IIIa antagonists

The GP IIb/IIIa receptor antagonists have been shown to significantly increase the success rate of invasive cardiovascular procedures, such as percutaneous transluminal coronary angioplasty. However, this benefit comes at a significant cost. The number of alternatives in this therapeutic area necessitates comparative evaluation of the costs and benefits of these products. Several study designs and methodological approaches can be used to evaluate the cost effectiveness of these products, including clinical trials, naturalistic trials, retrospective claims data, and modeling. This article discusses the advantages and disadvantages of the various approaches. Using decision analysis, this article takes the reader through the steps necessary to obtain average and incremental cost-effectiveness ratios. The analysis follows a step-by-step process that decision makers should be able to use as a framework to conduct a full comparative cost-effectiveness analysis.