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|Title:||A cost-utility analysis of clopidogrel in patients with ST elevation acute coronary syndromes in the UK|
|Citation:||International Journal of Cardiology, 2010; 140(3):315-322|
|Publisher:||Elsevier Sci Ireland Ltd|
|Jonathan Karnon, Mike W. Holmes, Robert Williams, Ameet Bakhai, Alan Brennan|
|Abstract:||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. For the 1-year treatment option both trials have ICERs below £4000. 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.|
|Keywords:||ST elevation acute myocardial infarction (STEMI); Aspirin, Clopidogrel; Cost effectiveness; Markov model; QALYs|
|Rights:||Copyright © 2008 Elsevier Ireland Ltd. All rights reserved.|
|Appears in Collections:||Public Health publications|
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