Clevidipine is an intravenous (IV) dihydropyridine calcium channel blocker indicated for the reduction of blood pressure (BP) when oral therapy is not feasible or not desirable. The aim of this cost consequence analysis was to estimate the economics and consequences of varying clevidipine utilization for BP management in patients experiencing neurological emergencies.

A decision analytic model was developed to simulate the costs and consequences associated with the use of clevidipine, labetalol, and nicardipine in patients experiencing a neurological emergency with acute hypertension. The outcomes were quantified from a US hospital perspective over a 3-year time horizon. The utilization of IV-antihypertensives was calculated using a combination of purchase history and Diagnosis Related Group (DRG) claims. Low and high clevidipine adopter profiles were formed using a retrospective analysis of IV-antihypertensive purchases in hospitals above the median of neurological emergency claims. A change in utilization was modelled from the low adopter profile with a linear increase over 3 years to the high adopter profile. Infusion rates were based on customer survey data on file. Drug costs were based on wholesale acquisition costs from ProspectoRx. Clinical inputs, and dosing information were based on literature.

For a hypothetical caseload of 100 neurological emergency patients, the use of clevidipine resulted in 9 more patients reaching BP target in 1 hr and the average time to reach BP target was 14.2 min faster. Additionally, there were 27 fewer cases of concomitant or subsequent IV-antihypertensive use. The average infusion volume of the primary drug was reduced by 591 mL per patient. The average drug costs decreased by $141 per patient.

The increased use of clevidipine for patients with a neurological emergency with acute hypertension results in more patients reaching BP target in less time with a decrease in the cost over the 3 years.