Economic Burden Evaluation of Adverse Events Caused by Antiplatelet Drugs in ACS Patients Using Markov-Monte Carlo Model / 中国药房

ABSTRACT

OBJECTIVE： To provide decision basis for antiplatelet therapy in ACS patients. METHODS： Markov model was established by collecting the related data in PLATO and TREAR study. Total bleeding risk， major bleeding risk， secondary bleeding risk and fatal bleeding risk in ACS patients who using ticagrelor or clopidogrel were calculated. Transfer probability， the cost and utility value between each state were collected and calculated according to previous literatures. The medical expenses of different methods were calculated by using TreeAge Pro 2011 software to obtain quality-adjusted life years （QALYs） and increment-cost- effectiveness ratio （ICER）. Furthermore， single-factor sensitivity analysis and probability sensitivity analysis were carried out. RESULTS： The average total cost of ticagrelor group was 66 449.38 yuan， obtaining 7.34 QALYs； the average total cost of clopidogrel group was 53 846.03 yuan， obtaining 6.68 QALYs. Compared with the clopidogrel group， the ICER of the ticagrelor group was 19 095.98 yuan/QALYs， that is， for each additional QALYs obtained， the cost of ticagrelor group was 19 095.98 yuan， less than willingness to pay threshold （64 644 yuan）. Sensitivity analysis was consistent with above analysis. CONCLUSIONS： Compared with clopidogrel， ticagrelor has less economic burden in ACS patients， especially in the patients with adverse bleeding events.