Health Technology Assessment of TNK-ase vs. Reteplase in the Treatment of Acute Myocardial Infarction in Iran

Health Technology Assessment of TNK-ase vs. Reteplase in the Treatment of Acute Myocardial Infarction in Iran Bashzar Salman1,2*, Tourani Sogand3, Nikfar Shekoufeh4, Ravaghi Hamid3, Habibi Maryam5 1. MSc, Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran 2. Ph.D Student, Student Research Committee, Department of Research and Technology, Kerman University of medical Sciences, Kerman, Iran 3. Associate Professor, Department of Health Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran 4. Associate Professor, Department of Pharmaceutical Economics and Management, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran 5. MD, Internal Medicine Assistant, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran *Correspondence: Department of Health Management, School of Health Management and Information Sciences, Rashid Yasemi St., Valiasr St., Tehran, Iran Tel: 00982188794301 Email: Sbashzar03@gmail.com Abstract: Background & Objectives: Due to the lack of evidence about the most cost-effective thrombolytic drug in the treatment of acute myocardial infarction with the ascension of the ST segment, this study was conducted to evaluate the cost effectiveness of tenecteplase, as a new medicine, versus Reteplase in the treatment of acute myocardial infarction patients with the ascension of the ST segment in Iran. Methods: This study was a type of health technology assessment study. We searched the MEDLINE, Cochrane Library (DARE-EED-HTA, Web of Science and EMBASE databases (from March1980 to March 2017) by using related keywords for finding cost-effectiveness, safety and economic studies. The qualities of studies were independently assessed by STROBE checklist and data were extracted using Cochrane data extraction form. Results: Three studies were eligible for inclusion and all three were of high quality. Mortality had been compared between Tenecteplase and Reteplase. The results of two studies with 781 samples had showed the same efficacy for Tenecteplase and Reteplase in regard to mortality rate. According to the cost-effectiveness analysis, Reteplase is more cost effective than TNK-ase (250 $ versus 537.49 $). Conclusion: Reteplase, due to the same safety and effictiveness but lower cost, is preferred to Te