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Lifetime cost-effectiveness analysis of ticagrelor in patients with acute coronary syndromes based on the PLATO trial: a Singapore healthcare perspective
Singapore medical journal ; : 169-175, 2013.
Artigo em Inglês | WPRIM | ID: wpr-335425
ABSTRACT
<p><b>INTRODUCTION</b>Ticagrelor is a novel antiplatelet drug developed to reduce atherothrombosis. The PLATO trial compared ticagrelor and aspirin to clopidogrel and aspirin in patients with acute coronary syndromes (ACS). Ticagrelor was found to be superior in the primary composite endpoint of cardiovascular death, myocardial infarction or stroke, without increasing major bleeding events. The current study estimates the lifetime cost-effectiveness of ticagrelor relative to generic clopidogrel from a Singapore public healthcare perspective.</p><p><b>METHODS</b>This study used a two-part cost-effectiveness model. The first part was a 12-month decision tree (using PLATO trial data) to estimate the rates of major cardiovascular events, healthcare costs and health-related quality of life. The second part was a Markov model estimating lifetime quality-adjusted survival and costs conditional on events during the initial 12 months. Daily drug costs applied were SGD 1.05 (generic clopidogrel) and SGD 6.00 (ticagrelor). Cost per quality-adjusted life years (QALY) was estimated from a Singapore public healthcare perspective using life tables and short-term costs from Singapore, and long-term costs from South Korea. Deterministic and probabilistic sensitivity analyses were performed.</p><p><b>RESULTS</b>Ticagrelor was associated with a lifetime QALY gain of 0.13, primarily driven by lower mortality. The resulting incremental cost per QALY gained was SGD 10,136.00. Probabilistic sensitivity analysis indicated that ticagrelor had a > 99% probability of being cost-effective, given the lower recommended WHO willingness-to-pay threshold of one GDP/capita per QALY.</p><p><b>CONCLUSION</b>Based on PLATO trial data, one-year treatment with ticagrelor versus generic clopidogrel in patients with ACS, relative to WHO reference standards, is cost-effective from a Singapore public healthcare perspective.</p>
Assuntos
Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Singapura / Ticlopidina / Árvores de Decisões / Inibidores da Agregação Plaquetária / Adenosina / Aspirina / Ensaios Clínicos como Assunto / Cadeias de Markov / Custos de Medicamentos / Análise Custo-Benefício Tipo de estudo: Estudos de avaliação / Guia de Prática Clínica / Avaliação Econômica em Saúde / Estudo prognóstico Limite: Humanos País/Região como assunto: Ásia Idioma: Inglês Revista: Singapore medical journal Ano de publicação: 2013 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Singapura / Ticlopidina / Árvores de Decisões / Inibidores da Agregação Plaquetária / Adenosina / Aspirina / Ensaios Clínicos como Assunto / Cadeias de Markov / Custos de Medicamentos / Análise Custo-Benefício Tipo de estudo: Estudos de avaliação / Guia de Prática Clínica / Avaliação Econômica em Saúde / Estudo prognóstico Limite: Humanos País/Região como assunto: Ásia Idioma: Inglês Revista: Singapore medical journal Ano de publicação: 2013 Tipo de documento: Artigo