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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

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Published copy (DOI)

Author(s)

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

Department/unit(s)

Publication details

JournalJournal of Medical Economics
DatePublished - 1 Jan 2013
Issue number4
Volume16
Pages (from-to)510-521
Original languageEnglish

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' (

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