[Short-and long-term cost-effectiveness analysis of adding clopidogrel to standard therapy in acute coronary syndrome patients in Spain].
OBJECTIVE
The CURE study showed that adding clopidogrel to standard therapy with acetylsalicylic acid reduces the risk of cardiovascular events (i.e., stroke, myocardial infarction, and cardiovascular death) in patients with acute coronary syndrome but without ST-segment elevation. The objective of this study was to carry out short- and long-term cost-effectiveness analyses of administering clopidogrel in addition to standard therapy during the first year of treatment.


METHODS
For the short-term analysis, clinical data and information on health resource utilization were taken from the CURE study. For the long-term analysis, an adaptation of an internationally used Markov model involving six health states was employed. Clinical data were obtained from clinical trials and epidemiological studies. Information on resource use was obtained from two Spanish registries of patients with acute coronary syndrome, a literature review, and consultations with an expert panel. Results are expressed in terms of incremental cost per event avoided or per life-year gained.


RESULTS
In the short-term analysis, the incremental cost per event avoided of adding clopidogrel to standard therapy was ;17 190. In the long-term analysis, the incremental cost per life-year gained was ;8132, which is below the Spanish cost-effectiveness threshold of ;30 000 per life-year gained.


CONCLUSIONS
Adding clopidogrel to standard therapy during the first year of treatment is cost-effective in both the short and long term.
Badia
Xavier
X
Department of Health Outcomes Policy and Economics, Health Outcomes Research Europe, Barcelona, Spain. xbadia@hor-europe.com
Bueno
Héctor
H
González Juanatey
José R
JR
Valentín
Vicent
V
Rubio
Marta
M
D002317:Cardiovascular Agents / Q000191:economics / Q000627:therapeutic use; D000077144:Clopidogrel; D003362:Cost-Benefit Analysis; D006801:Humans; D018803:Models, Economic; D017202:Myocardial Ischemia / Q000188:drug therapy / Q000191:economics*; D010975:Platelet Aggregation Inhibitors / Q000191:economics* / Q000627:therapeutic use; D013030:Spain; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D016896:Treatment Outcome
D002317:Cardiovascular Agents; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine