title: PHARMAC and lack of funding for clopidogrel.
abstract: Clopidogrel is an antiplatelet drug that has been shown in several trials to reduce clinical events such as cardiovascular death, stroke, and myocardial infarction when compared to aspirin in a broad range of patients with atherosclerotic vascular disease. Clopidogrel has also been shown to reduce the same events by 20% when added to aspirin in patients with unstable angina and also in patients undergoing coronary artery stenting. Despite this information being available for 5 to 10 years, guideline recommendations, and the knowledge that 5% of patients have major allergy to aspirin, New Zealand patients have only been able to receive funded clopidogrel for a short period, typically 3 weeks, after coronary artery stenting. We believe this is an example where New Zealanders have been denied treatments, despite a strong evidence-base, by PHARMAC's actions of delaying the funding of new drugs. We need to have a better process whereby New Zealanders can rapidly access new treatments.
authors.affiliation: Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand. harveyw@adhb.govt.nz
authors.forename: Harvey
authors.initials: H
authors.lastname: White
authors.forename: Chris
authors.initials: C
authors.lastname: Ellis
mesh_terms: D000077144:Clopidogrel; D003362:Cost-Benefit Analysis; D004341:Drug Evaluation; D033161:Government Regulation; D006801:Humans; D009313:National Health Programs / Q000191:economics*; D009520:New Zealand; D010975:Platelet Aggregation Inhibitors / Q000191:economics*; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000191:economics
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine