Economic Evaluation of the Drugs Used In Treating Patients with Myocardial Infarction: A Systematic Review

  Myocardial infarctions (MI), as one of the outcomes of cardiovascular diseases, are responsible for 20% of deaths, so that every 30 seconds, one person suffers from MI. Various drugs are used to treat myocardial infarction, and we need to have precise information of the cost-effectiveness of these drugs. The aim of this study was to examine economic evaluation of the drugs used for treatment of patients with MI. In the present systematic review study, published articles related to economic evaluation of the drugs used for treatment of patients with MI within the time interval between 2000 and 2017 were searched, using electronic databases such as Tufts Medical Center Cost-Effectiveness Analysis Registry ,Cochrane library, NHS Economic Evaluations Database Medline, PubMed, Google scholar, web of science using the following keywords:Cost- effectiveness* OR cost- utility* OR economic evaluation * AND (myocardial infarction *) AND (angiotensin- converting enzyme inhibitor (lisinopril) OR thrombolytic agents (streptokinase, anistreplase or anisoylated plasminogen streptokinase activator complex OR beta blockers (metoprolol, propranolol, atenolol, acebutolol, bisoprolol). Due to heterogeneity in the outcome, we were not able to use meta-analysis. Methodological quality of the structuree of tarticles was examined by Drummond’s standard checklist. Based on the inclusion criteria, the search of databases resulted in 12 articles that fully covered economic evaluation of the drugs used in treating patients with MI. The of the present study indicated that a streptokinase and t-PA drug for treatment of patients with myocardial infarction was cost-effective. The results showed that most of the studies clearly stated the time horizon of the study and included direct medical costs in their analysis. In addition, the majority of the studies were used the Markov model. The quality-adjusted life years (QALYs) were the main outcome used for measuring the effectiveness. The results of the present study showed that a thrombolytic agent for treatment of patients with myocardial infarction was cost-effective. The results were relatively varied due to the differences in time horizon and variables used in the models such as efficacy and drug prices. Furthermore, these studies were designed and conducted in high-income countries; thus, the application of these results in low- and middle-income countries will be limited.