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Health economic analysis of ticagrelor in patients with acute coronary syndromes intended for non-invasive therapy
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.ORCID iD: 0000-0002-9375-5087
Uppsala Univ, Dept Med Sci, Uppsala, Sweden Uppsala Univ, Uppsala Clin Res Ctr, Uppsala, Sweden.
] Brigham & Womens Hosp, Thrombolysis Myocardial Infarct TIMI Study Grp, Boston, MA 02115 USA Harvard Univ, Sch Med, Boston, MA USA .
Univ Sheffield, Dept Cardiovasc Sci, Sheffield, S Yorkshire, England.
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2015 (English)In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 101, no 2, 119-25 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To investigate the cost effectiveness of ticagrelor versus clopidogrel in patients with acute coronary syndromes (ACS) in the Platelet Inhibition and Patient Outcomes (PLATO) study who were scheduled for non-invasive management.

METHODS: A previously developed cost effectiveness model was used to estimate long-term costs and outcomes for patients scheduled for non-invasive management. Healthcare costs, event rates and health-related quality of life under treatment with either ticagrelor or clopidogrel over 12 months were estimated from the PLATO study. Long-term costs and health outcomes were estimated based on data from PLATO and published literature sources. To investigate the importance of different healthcare cost structures and life expectancy for the results, the analysis was carried out from the perspectives of the Swedish, UK, German and Brazilian public healthcare systems.

RESULTS: Ticagrelor was associated with lifetime quality-adjusted life-year (QALY) gains of 0.17 in Sweden, 0.16 in the UK, 0.17 in Germany and 0.13 in Brazil compared with generic clopidogrel, with increased healthcare costs of €467, €551, €739 and €574, respectively. The cost per QALY gained with ticagrelor was €2747, €3395, €4419 and €4471 from a Swedish, UK, German and Brazilian public healthcare system perspective, respectively. Probabilistic sensitivity analyses indicated that the cost per QALY gained with ticagrelor was below conventional threshold values of cost effectiveness with a high probability.

CONCLUSIONS: Treatment of patients with ACS scheduled for 12 months' non-invasive management with ticagrelor is associated with a cost per QALY gained below conventional threshold values of cost effectiveness compared with generic clopidogrel.


Place, publisher, year, edition, pages
2015. Vol. 101, no 2, 119-25 p.
National Category
Clinical Medicine
URN: urn:nbn:se:liu:diva-113396DOI: 10.1136/heartjnl-2014-305864ISI: 000347459800008PubMedID: 25227704OAI: diva2:781614
Available from: 2015-01-17 Created: 2015-01-17 Last updated: 2016-04-14

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Janzon, MagnusHenriksson, Martin
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Division of Cardiovascular MedicineFaculty of Medicine and Health SciencesDepartment of Cardiology in LinköpingDivision of Health Care Analysis
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