Cost-Effectiveness of Ticagrelor Compared with Clopidogrel in Patients with Acute Coronary Syndrome from Vietnamese Healthcare Payers' Perspective.

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From: Advances in Therapy(Vol. 38, Issue 7)
Publisher: Springer
Document Type: Report; Brief article
Length: 337 words

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Keywords: Ticagrelor; Clopidogrel; Acute coronary syndrome; Cost-effectiveness analysis; Vietnam Abstract Introduction The PLATelet inhibition and patient Outcomes (PLATO) trial (NCT00391872) demonstrated that ticagrelor compared to clopidogrel significantly reduced the rate of death from cardiovascular causes, myocardial infarction or stroke in patients with acute coronary syndrome (ACS). The aim of this study is to analyze the long-term cost-effectiveness of ticagrelor compared to clopidogrel in ACS patients from a Vietnamese healthcare payers' perspective. Methods A two-part cost-effectiveness model was developed to estimate long-term costs and quality-adjusted life-years (QALY). Cardiovascular event rates, hospital bed days, interventions, investigations, study drug utilization and EuroQol 5 Dimension (EQ-5D) data were derived from the PLATO trial. Unit costs of medical services were derived from the Vietnamese governmental price list, and drug costs were based on the weighted average price from the Vietnamese social security report (in VND 10.000 VND=0.405 USD). An annual discount rate of 3% was used. Probabilistic and deterministic sensitivity analyses were conducted to evaluate uncertainty of the results. Results Ticagrelor was associated with an incremental cost of VND 5.34 million (USD 216.49) and a QALY gain of 0.11. This resulted in a cost per QALY gained of VND 49.58 million (USD 2009.96) from the Vietnamese healthcare payers' perspective. Probabilistic sensitivity analysis indicates that ticagrelor has 59% probability of being cost-effective compared with clopidogrel when using a willingness-to-pay threshold of one gross domestic products (GDP) per capita. Deterministic sensitivity analysis using clinical outcomes from the Asian sub-population of PLATO resulted in a cost per QALY of VND 42.25 million (USD 1712.80). Conclusion Ticagrelor can be considered a cost-effective treatment for ACS compared with clopidogrel from a Vietnamese healthcare payers' perspective. Author Affiliation: (1) University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam (2) AstraZeneca, CVRM BioPharmaceuticals, Gothenburg, Sweden (3) Hanoi Heart Hospital, Hanoi, Vietnam (4) Vietnam Heart Institute, Hanoi, Vietnam (5) AstraZeneca Medical Affairs, Ho Chi Minh City, Vietnam (a) nguyenthuthuy@ump.edu.vn Article History: Registration Date: 04/10/2021 Received Date: 03/02/2021 Accepted Date: 04/10/2021 Online Date: 06/11/2021 Byline:

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Gale Document Number: GALE|A668566383