Cost-effectiveness of ticagrelor and generic clopidogrel in patients with acute coronary syndrome in Switzerland
QUESTION UNDER STUDY: The aim of this study was to evaluate the cost-effectiveness of ticagrelor and generic clopidogrel as add-on therapy to acetylsalicylic acid (ASA) in patients with acute coronary syndrome (ACS), from a Swiss perspective. METHODS: Based on the PLATelet inhibition...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2013-09-01
|
| Series: | Swiss Medical Weekly |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/1748 |
| _version_ | 1798003528694759424 |
|---|---|
| author | David Gasche Tanja Ulle Bernhard Meier Roger-Axel Greiner |
| author_facet | David Gasche Tanja Ulle Bernhard Meier Roger-Axel Greiner |
| author_sort | David Gasche |
| collection | DOAJ |
| description |
QUESTION UNDER STUDY: The aim of this study was to evaluate the cost-effectiveness of ticagrelor and generic clopidogrel as add-on therapy to acetylsalicylic acid (ASA) in patients with acute coronary syndrome (ACS), from a Swiss perspective.
METHODS: Based on the PLATelet inhibition and patient Outcomes (PLATO) trial, one-year mean healthcare costs per patient treated with ticagrelor or generic clopidogrel were analysed from a payer perspective in 2011. A two-part decision-analytic model estimated treatment costs, quality-adjusted life years (QALYs), life years and the cost-effectiveness of ticagrelor and generic clopidogrel in patients with ACS up to a lifetime at a discount of 2.5% per annum. Sensitivity analyses were performed.
RESULTS: Over a patient’s lifetime, treatment with ticagrelor generates an additional 0.1694 QALYs and 0.1999 life years at a cost of CHF 260 compared with generic clopidogrel. This results in an Incremental Cost Effectiveness Ratio (ICER) of CHF 1,536 per QALY and CHF 1,301 per life year gained. Ticagrelor dominated generic clopidogrel over the five-year and one-year periods with treatment generating cost savings of CHF 224 and 372 while gaining 0.0461 and 0.0051 QALYs and moreover 0.0517 and 0.0062 life years, respectively. Univariate sensitivity analyses confirmed the dominant position of ticagrelor in the first five years and probabilistic sensitivity analyses showed a high probability of cost-effectiveness over a lifetime.
CONCLUSION: During the first five years after ACS, treatment with ticagrelor dominates generic clopidogrel in Switzerland. Over a patient’s lifetime, ticagrelor is highly cost-effective compared with generic clopidogrel, proven by ICERs significantly below commonly accepted willingness-to-pay thresholds.
|
| first_indexed | 2024-04-11T12:09:07Z |
| format | Article |
| id | doaj.art-0c7e975f38764d6e8dddfa4b39a647c0 |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2024-04-11T12:09:07Z |
| publishDate | 2013-09-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-0c7e975f38764d6e8dddfa4b39a647c02022-12-22T04:24:39ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972013-09-01143373810.4414/smw.2013.13851Cost-effectiveness of ticagrelor and generic clopidogrel in patients with acute coronary syndrome in SwitzerlandDavid GascheTanja UlleBernhard MeierRoger-Axel Greiner QUESTION UNDER STUDY: The aim of this study was to evaluate the cost-effectiveness of ticagrelor and generic clopidogrel as add-on therapy to acetylsalicylic acid (ASA) in patients with acute coronary syndrome (ACS), from a Swiss perspective. METHODS: Based on the PLATelet inhibition and patient Outcomes (PLATO) trial, one-year mean healthcare costs per patient treated with ticagrelor or generic clopidogrel were analysed from a payer perspective in 2011. A two-part decision-analytic model estimated treatment costs, quality-adjusted life years (QALYs), life years and the cost-effectiveness of ticagrelor and generic clopidogrel in patients with ACS up to a lifetime at a discount of 2.5% per annum. Sensitivity analyses were performed. RESULTS: Over a patient’s lifetime, treatment with ticagrelor generates an additional 0.1694 QALYs and 0.1999 life years at a cost of CHF 260 compared with generic clopidogrel. This results in an Incremental Cost Effectiveness Ratio (ICER) of CHF 1,536 per QALY and CHF 1,301 per life year gained. Ticagrelor dominated generic clopidogrel over the five-year and one-year periods with treatment generating cost savings of CHF 224 and 372 while gaining 0.0461 and 0.0051 QALYs and moreover 0.0517 and 0.0062 life years, respectively. Univariate sensitivity analyses confirmed the dominant position of ticagrelor in the first five years and probabilistic sensitivity analyses showed a high probability of cost-effectiveness over a lifetime. CONCLUSION: During the first five years after ACS, treatment with ticagrelor dominates generic clopidogrel in Switzerland. Over a patient’s lifetime, ticagrelor is highly cost-effective compared with generic clopidogrel, proven by ICERs significantly below commonly accepted willingness-to-pay thresholds. https://www.smw.ch/index.php/smw/article/view/1748 |
| spellingShingle | David Gasche Tanja Ulle Bernhard Meier Roger-Axel Greiner Cost-effectiveness of ticagrelor and generic clopidogrel in patients with acute coronary syndrome in Switzerland Swiss Medical Weekly |
| title | Cost-effectiveness of ticagrelor and generic clopidogrel in patients with acute coronary syndrome in Switzerland |
| title_full | Cost-effectiveness of ticagrelor and generic clopidogrel in patients with acute coronary syndrome in Switzerland |
| title_fullStr | Cost-effectiveness of ticagrelor and generic clopidogrel in patients with acute coronary syndrome in Switzerland |
| title_full_unstemmed | Cost-effectiveness of ticagrelor and generic clopidogrel in patients with acute coronary syndrome in Switzerland |
| title_short | Cost-effectiveness of ticagrelor and generic clopidogrel in patients with acute coronary syndrome in Switzerland |
| title_sort | cost effectiveness of ticagrelor and generic clopidogrel in patients with acute coronary syndrome in switzerland |
| url | https://www.smw.ch/index.php/smw/article/view/1748 |
| work_keys_str_mv | AT davidgasche costeffectivenessofticagrelorandgenericclopidogrelinpatientswithacutecoronarysyndromeinswitzerland AT tanjaulle costeffectivenessofticagrelorandgenericclopidogrelinpatientswithacutecoronarysyndromeinswitzerland AT bernhardmeier costeffectivenessofticagrelorandgenericclopidogrelinpatientswithacutecoronarysyndromeinswitzerland AT rogeraxelgreiner costeffectivenessofticagrelorandgenericclopidogrelinpatientswithacutecoronarysyndromeinswitzerland |