| A cost-utility analysis of clopidogrel in patients with ST elevation acute coronary syndromes in the UK. | |
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MedLine Citation:
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PMID: 19106007 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To assess the long-term cost effectiveness of treatment for 1 month, and for 1 year with clopidogrel in addition to standard therapy (including aspirin) compared with standard therapy alone, in patients diagnosed with ST elevation acute myocardial infarction (STEMI) in the UK. DESIGN: Cost utility analysis using a cohort Markov model, incorporating clinical data from two pivotal clinical trials (the COMMIT/CCS-2 and CLARITY-TIMI 28 trials) and data from UK and non-UK observational studies. SETTING: Health economic evaluation carried out from the perspective of the UK NHS. PATIENTS: A representative cohort of 1000 UK patients aged 60 years, diagnosed with STEMI. INTERVENTIONS: 75 mg/day clopidogrel, with and without a 300 mg loading dose, in addition to standard therapy (including aspirin, 75-325 mg/day) for 1 month, and for 1 year, followed by standard therapy alone for their remaining lifetime, or standard therapy alone (including aspirin, 75-325 mg/day) for their remaining lifetime. MAIN OUTCOME MEASURES: Incremental cost per quality-adjusted life-year (QALY) gained (ICER). RESULTS: For the 1-month treatment option both the COMMIT/CCS-2 and CLARITY-TIMI 28 trials have ICERs below 2500 pounds. For the 1-year treatment option both trials have ICERs below 4000 pounds. Extensive univariate and probabilistic sensitivity analyses showed these results to be robust. CONCLUSIONS: In combination with previous economic analyses of clopidogrel in NSTEMI patients, this paper demonstrates that clopidogrel appears to offer a cost-effective treatment option for all ACS patients. |
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Authors:
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Jonathan Karnon; Mike W Holmes; Robert Williams; Ameet Bakhai; Alan Brennan |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2008-12-23 |
Journal Detail:
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Title: International journal of cardiology Volume: 140 ISSN: 1874-1754 ISO Abbreviation: Int. J. Cardiol. Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-04-26 Completed Date: 2010-07-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: Netherlands |
Other Details:
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Languages: eng Pagination: 315-22 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2008 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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School of Population Health and Clinical Practice, University of Adelaide, Adelaide, Australia. jonathan.karnon@adelaide.edu.au |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aspirin
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economics,
therapeutic use Cost-Benefit Analysis Drug Costs* Follow-Up Studies Great Britain Humans Markov Chains Middle Aged Models, Econometric Myocardial Infarction / drug therapy* Platelet Aggregation Inhibitors / economics*, therapeutic use Quality-Adjusted Life Years Survival Analysis Ticlopidine / analogs & derivatives*, economics, therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin; 55142-85-3/Ticlopidine; 90055-48-4/clopidogrel |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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