Document Detail


A cost-utility analysis of clopidogrel in patients with ST elevation acute coronary syndromes in the UK.
MedLine Citation:
PMID:  19106007     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Jonathan Karnon; Mike W Holmes; Robert Williams; Ameet Bakhai; Alan Brennan
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-12-23
Journal Detail:
Title:  International journal of cardiology     Volume:  140     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-26     Completed Date:  2010-07-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  315-22     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2008 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
School of Population Health and Clinical Practice, University of Adelaide, Adelaide, Australia. jonathan.karnon@adelaide.edu.au
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MeSH Terms
Descriptor/Qualifier:
Aspirin / 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:
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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