[An acetylsalicylic acid-dypiridamole combination (Asasantine) in the prevention of the recurrence of cerebrovascular accidents (a cost-effectiveness analysis)].
On the basis of the results of the European stroke Prevention Study (ESPS 2) obtained on 6,602 patients, we used a Markov model to perform a cost-effectiveness analysis of a combination of a low-dose of acetylsalicylic acid (ASA) (25 mg b.i.d.) and sustained-release dipyridamole (DP) (200 mg b.i.d.) versus a low-dose of acetylsalicylic acid alone in the prevention of recurrent stroke in Belgium. The perspective was that of the Social Security. Total costs per patient over 5 years amounted to 1,317,718 FB for placebo, 1,312,015 FB for ASA and 1,326,526 FB for ASA-DP, with respectively 3.16, 3.25 and 3.33 stroke-free life years (SFLY). For 1,000 patients followed over 5 years, the number of SFLYs gained by ASA-DP is 170 when compared to placebo and 100 when compared to ASA. As compared to placebo, ASA is a dominant strategy and the combination AAS-DP has a cost-effectiveness ratio of 50,569 FB per SFLY gained. The cost-effectiveness ratio of ASA-DP vs. ASA was 176,963 FB per SFLY gained and was not substantially modified in sensitivity analyses. The favourable cost-effectiveness ratio for ASA-DP is mainly explained by the reduction of costs associated with the acute treatment of stroke.
Laboratoire de Pharmacologie, Université de Liège.
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Annemans
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D001241:Aspirin / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D000068342:Aspirin, Dipyridamole Drug Combination; D001530:Belgium; D002561:Cerebrovascular Disorders / Q000191:economics / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D003692:Delayed-Action Preparations; D004176:Dipyridamole / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D018572:Disease-Free Survival; D004338:Drug Combinations; D016527:Drug Costs; D017850:Economics, Pharmaceutical; D005500:Follow-Up Studies; D006801:Humans; D008390:Markov Chains; D010919:Placebos; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D012008:Recurrence; D012680:Sensitivity and Specificity; D012943:Social Security / Q000191:economics
D000068342:Aspirin, Dipyridamole Drug Combination; D003692:Delayed-Action Preparations; D004338:Drug Combinations; D010919:Placebos; D010975:Platelet Aggregation Inhibitors; D004176:Dipyridamole; D001241:Aspirin