title: Ticagrelor treatment in patients with acute coronary syndrome is cost-effective in Sweden and Denmark.
abstract: OBJECTIVE
  To evaluate the cost-effectiveness of treating patients with acute coronary syndromes (ACS) for 12 months with ticagrelor compared with generic clopidogrel in Sweden and Denmark.
  
  
  METHODS
  Decision-analytic model to estimate lifetime costs, life-expectancy, and quality-adjusted life years (QALYs) with ticagrelor and clopidogrel. Event rates, healthcare resource use, and health-related quality of life during 12 months of therapy were estimated from the PLATelet inhibition and patient Outcomes (PLATO) trial. Beyond 12 months, quality-adjusted survival and costs were estimated conditional on events occurring during the 12 months of therapy. When available, country-specific data were employed in the analysis. Incremental cost-effectiveness ratios are presented from a healthcare perspective and a broader societal perspective including costs falling outside the healthcare sector in 2010 local currency.
  
  
  RESULTS
  The cost per QALY with ticagrelor compared with generic clopidogrel was SEK 25 022 and DKK 26 892 for Sweden and Denmark, respectively, from a healthcare perspective. The cost per QALY from a broader societal perspective was SEK 24 290 and DKK 25 051 for Sweden and Denmark, respectively.
  
  
  CONCLUSIONS
  The cost per QALY of treating ACS-patients with ticagrelor compared with generic clopidogrel is below the conventional thresholds of cost-effectiveness in Sweden and Denmark.
authors.affiliation: Department for Medical and Health Sciences, Center for Medical Technology Assessment, Linköping University , Linköping , Sweden.
authors.forename: Martin
authors.initials: M
authors.lastname: Henriksson
authors.forename: Elisabet
authors.initials: E
authors.lastname: Nikolic
authors.forename: Audun
authors.initials: A
authors.lastname: Ohna
authors.forename: Lars
authors.initials: L
authors.lastname: Wallentin
authors.forename: Magnus
authors.initials: M
authors.lastname: Janzon
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy*; D000241:Adenosine / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D000077144:Clopidogrel; D003362:Cost-Benefit Analysis; D003718:Denmark; D006801:Humans; D058921:Purinergic P2Y Receptor Antagonists / Q000191:economics* / Q000627:therapeutic use; D013548:Sweden; D000077486:Ticagrelor; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use
chemical_list: D058921:Purinergic P2Y Receptor Antagonists; D000077144:Clopidogrel; D000077486:Ticagrelor; D000241:Adenosine; D013988:Ticlopidine
keywords: acute coronary syndrome; clopidogrel; cost-effectiveness analysis; quality-adjusted life years; ticagrelor