Omkostningseffektivitet ved clopidogrel- versus acetylsalicylsyrebehandling af höjrisikopatienter med akut koronarsyndrom i Danmark
Engelsk titel: Cost-effectiveness of clopidogrel versus aspirin treatment in high-risk acute coronary syndrome patients in Denmark
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Författare:
Heeg B
;
van Gestel A
;
van Hout B
;
Olsen J
;
Haghfelt TH
Email: jeo@cast.sdu.dk
Språk: Dan
Antal referenser: 20
Dokumenttyp:
Artikel
UI-nummer: 06081772
Sammanfattning
Introduction: The aim of this study was to estimate the cost-effectiveness of clopidogrel versus aspirin (ASA) in Denmark in the secondary prevention of cardiovascular events in three high-risk CAPRIE populations: (1) patients with a history of coronary artery bypass grafting, (2) patients with a history of ischemic events and (3) patients with multiple vascular territory involvement. Additionally, the cost-effectiveness of clopidogrel versus no treatment in ASA-intolerant patients was estimated. Materials and methods: Clinical, epidemiological and cost data (Danish estimates) were combined in a Markov model. Estimates of transition probabilities were derived from post hoc analyses of the CAPRIE database. Results: Cost-effectiveness (CE) ratios ranged from 25,445 Danish kroner per LYG (life year gained) in patients with a history of CABG to 55,503 Danish kroner per LYG in patients with multiple vascular territory involvement. The estimated cost-effectiveness ratio of clopidogrel in ASA-intolerant patients was significantly lower (3,093 Danish kroner per LYG). Sensitivity analyses showed that the order of magnitude of these CE ratios is unaffected by changes in model assumptions. Conclusion: In a Danish setting, clopidogrel may be considered a cost-effective treatment alternative to ASA for the secondary prevention of cardiovascular events in high-risk populations. Clopidogrel is also an effective and cost-effective treatment for ASA-intolerant patients.