Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-19T11:59:36.320Z Has data issue: false hasContentIssue false

Economic Analysis of Tirilazad Mesylate for Aneurysmal Subarachnoid Hemorrhage: Economic Evaluation of a Phase III Clinical Trial in Europe and Australia

Published online by Cambridge University Press:  10 March 2009

Henry Glick
Affiliation:
University of Pennsylvania
Richard Willke
Affiliation:
Pharmacia & Upjohn, Inc.
Daniel Polsky
Affiliation:
University of Pennsylvania
Ted Llana
Affiliation:
Covance
Wayne M. Alves
Affiliation:
University of Virginia
Neal Kassell
Affiliation:
University of Virginia
Kevin Schulman
Affiliation:
Georgetown Medical Center

Abstract

This study used data from a multinational phase III randomized, double-blind, vehicle-controlled trial to evaluate the cost-effectiveness of tirilazad mesylate (Freedox®) in the treatment of aneurysmal subarachnoid hemorrhage. In men, therapy with 6 mg/kg per day of tirilazad mesylate was associated with significantly increased survival, increased cost of care, and ratios of cost per death averted that compare favorably with the ratios of other life and death interventions. In women, it appeared to have no effects on costs or survival. Further clinical studies may provide additional information about the cost-effectiveness of this intervention.

Type
General Essays
Copyright
Copyright © Cambridge University Press 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Barnett, G. H., & Whiting, D. Perioperative management of ruptured aneurysms. In A Wad, I. A., (ed.), Current Management of Cerebral Aneurysms. Park Ridge, III: American Association of Neurological Surgeons, 1993.Google Scholar
2.De Nino, L. A., Mulrow, C. D., Gerety, M. B., & Avery, E. C.Problems in interpreting cost effectiveness in clinical trials. Online Journal of Current Clinical Trials, 1993, 44.Google Scholar
3.Drummond, M. F., & Davies, L.Economic analysis alongside clinical trials: Revisiting the methodological issues. International Journal of Technology Assessment in Health Care, 1991, 7, 561–73.CrossRefGoogle ScholarPubMed
4.Duan, N.Smearing estimate: A nonparametric retransformation method. Journal of the American Statistical Association, 1983, 78, 605–10.CrossRefGoogle Scholar
5.Efron, B.Better bootstrap confidence intervals. Journal of the American Statistical Association, 1987, 82, 171–200.CrossRefGoogle Scholar
6.Efron, B., & Gong, G.A leisurely look at the bootstrap, jackknife and cross-validation. American Statistician, 1983, 37, 36.CrossRefGoogle Scholar
7.Efron, B.Nonparametric estimates of standard error: The jackknife, the bootstrap and other methods. Biometrica, 1981, 72, 4558.CrossRefGoogle Scholar
8.Eisenberg, J. M., Glick, H., & Koffer, H. Pharmacoeconomics: Economic evaluation of Pharmaceuticals. In Strom, B. L., (ed.), Pharmacoepidemiology. New York: Churchill Livingstone, 1989, 325–50.Google Scholar
9.Garraway, W. M., Whisnant, J. P., & Drury, I.The continuing decline in the incidence of stroke. Mayo Clinic Proceedings, 1983, 58, 520–23.Google ScholarPubMed
10.Glick, H.Strategies for economic assessment during the development of new drugs. Drug Information Journal, 1995, 29, 13911403.CrossRefGoogle Scholar
11.Goldman, L., Gordon, D. J., Rifkind, B. M., et al. Cost and health implications of cholesterol lowering. Circulation, 1992, 85, 1960–68.CrossRefGoogle ScholarPubMed
12.Haley, E. C., Kassell, N. F., Alves, W. M., et al. Phase two trial of tirilazad in aneurysmal subarachnoid hemorrhage: A report of the Cooperative Aneurysm Study. Journal of Neurosurgery, 1995, 82, 786–90.CrossRefGoogle ScholarPubMed
13.Haley, E. C., Kassell, N. E., Apperson-Hansen, C., et al. A randomized, double-blind, vehicle-controlled trial of tirilazad mesylate in patients with aneurysmal subarachnoid hemorrhage: A cooperative study in North America. Journal Neurosurgery, 1997, 86,467-74.CrossRefGoogle ScholarPubMed
14.Ingal, T. J., Whisnant, J. P., Wiebers, D. O., & O'Fallon, W. M.Has there been a decline in subarachnoid hemorrhage mortality? Stroke, 1989, 20, 718–24.CrossRefGoogle Scholar
15.Jennett, B., & Pickard, J.Economic aspects of neurosurgery. Advances and Technical Standards in Neurosurgery, 1992, 19, 124–43.Google ScholarPubMed
16.Kassell, N. F., Haley, E. C., Apperson-Hansen, C., & Alves, W. M.A randomized, double-blind, vehicle-controlled trial of tirilazad mesylate in patients with aneurysmal subarachnoid hemorrhage: A cooperative study in Europe/Australia/New Zealand. Journal of Neurosurgery, 1996, 84, 221–28.CrossRefGoogle Scholar
17.Kassell, N. F., Torner, J. C., Haley, C. Jr., & Adams, H. P.The international cooperative study on the timing of aneurysm surgery, part I: Overall management results. Journal of Neurosurgery, 1990, 73, 1836.CrossRefGoogle Scholar
18.The Multisociety Task Force on PVS. Medical aspects of the persistent vegetative state (first of two parts). New England Journal of Medicine, 1994, 330, 14991508.CrossRefGoogle Scholar
19.Office of Economic Coordination and Development. Main economic indicators. Paris: Publications of the OECD, 1993.Google Scholar
20.Patrick, D. L., & Erickson, P.Health status and health policy: Allocating resources to health care. Oxford: Oxford University Press, 1993.Google Scholar
21.Rosenorn, J. F., Eskesen, V., & Schmidt, K.Clinical features and outcome in 1076 patients with ruptured intracranial vascular aneurysms: A prospective consecutive study. British Journal of Neurosurgery, 1987, 1, 3346.CrossRefGoogle Scholar
22.Schmidley, J. W.Free radicals in central nervous system ischemia. Stroke, 1990, 21, 1086–90.CrossRefGoogle ScholarPubMed
23.Schulman, K. A., Buxton, M., Glick, H., et al. Results of the economic evaluation of the FIRST study: A multinational prospective economic evaluation. International Journal of Technology Assessment in Health Care, 1996, 12, 698713.CrossRefGoogle ScholarPubMed
24.Torner, J. C.Epidemiology of subarachnoid hemorrhage. Seminars in Neurology, 1984, 4, 354–69.CrossRefGoogle Scholar
25.U.S. Bureau of Labor Statistics. Employment and wages, annual averages. Washington, DC: U.S. Government Printing Office, 1992.Google Scholar
26.Vollmer, D. G., Kassell, N. F., Hongo, K., et al. Effect of nonglucocorticoid 21-aminosteroid U74006F on experimental cerebral vasospasm. Surgical Neurology, 1989, 31, 190–94.CrossRefGoogle Scholar
27.Willke, R. J.Pharmacoeconomic analysis of protocol P/2700/0032. Kalamazoo, MI: Upjohn Co., 02 28, 1995. Upjohn Technical Report 9124-95-003.Google Scholar