Prasugrel vs clopidogrel in patients with acute coronary syndrome undergoing percutaneous coronary intervention: A model-based cost-effectiveness analysis for Germany, Sweden, the Netherlands, and Turkey

A. Davies, A. Bakhai, C. Schmitt, A. Barrett, P. Graham-Clarke, M. Sculpher

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To evaluate the long-term cost-effectiveness of 12-months treatment with prasugrel vs clopidogrel from four European healthcare systems' perspectives (Germany, Sweden, the Netherlands, and Turkey). Methods: In the TRITON-TIMI 38 trial, patients with an acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) were treated with prasugrel or clopidogrel. Prasugrel reduced the composite end-point (cardiovascular death, MI, or stroke), but increased TIMI major bleeding. A Markov model was constructed to facilitate a lifetime horizon for the analysis. A series of risk equations constructed using individual patient data from TRITON-TIMI 38 was used to estimate risks of clinical events. Quality-adjusted life-years (QALYs) were derived by weighting survival time by estimates of health-related quality-of-life. Incremental cost-effectiveness is presented based on differences in treatments' mean costs and QALYs for the licensed population in TRITON-TIMI 38, and the sub-groups of UA-NSTEMI, STEMI, diabetes, and the 'core clinical cohort' (
Original languageEnglish
Pages (from-to)510-521
JournalJournal of Medical Economics
Volume16
Issue number4
DOIs
Publication statusPublished - 1 Jan 2013

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