[Economic evaluation of the treatment with aspirin plus esomeprazole compared to clopidogrel in gastrointestinal bleeding prevention].
OBJECTIVE
To evaluate the use of aspirin plus esomeprazole vs. clopidogrel in the prevention of gastrointestinal bleeding.


METHODS
We performed a cost-effectiveness analysis (two-branch decision tree: aspirin plus esomeprazole or clopidogrel) of prevention of gastrointestinal bleeding over a 2-year period, as well as sensitivity analyses.


RESULTS
The total cost of aspirin plus esomeprazole treatment (2,865 Euro/patient free of hemorrhage) was lower than that of clopidogrel (2,965 Euro). Aspirin treatment was dominant. The combination continued to be dominant in all sensitivity analyses. When esomeprazole 40 mg was substituted by omeprazole 40 mg, the cost of combination therapy decreased to 1,934 Euro/prevented hemorrhage.


CONCLUSIONS
The association of esomeprazole and aspirin is more cost-effective than clopidogrel in preventing gastrointestinal bleeding. Aspirin plus omeprazole was even more cost-effective.
Unidad de Farmacoeconomía y Relaciones Institucionales, Departamento de Investigación y Desarrollo, Química Farmacéutica Bayer, S.A., Barcelona, España. carmen.pinol.cp@bayer.es
Carme
C
Piñol
D001241:Aspirin / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D000077144:Clopidogrel; D003663:Decision Trees; D004359:Drug Therapy, Combination; D064098:Esomeprazole; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced / Q000191:economics* / Q000517:prevention & control*; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy*; D009853:Omeprazole / Q000191:economics* / Q000627:therapeutic use*; D010975:Platelet Aggregation Inhibitors / Q000191:economics* / Q000627:therapeutic use*; D054328:Proton Pump Inhibitors; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use
D010975:Platelet Aggregation Inhibitors; D054328:Proton Pump Inhibitors; D000077144:Clopidogrel; D009853:Omeprazole; D064098:Esomeprazole; D013988:Ticlopidine; D001241:Aspirin