title: Latin American Clinical Epidemiology Network Series - Paper 8: Ticagrelor was cost-effective vs. clopidogrel in acute coronary syndrome in Chile.
abstract: OBJECTIVE
  To evaluate the incremental cost-effectiveness ratio (ICER) of the use of ticagrelor as a substitute for clopidogrel for secondary prevention of acute coronary syndrome in Chile.
  
  
  METHODS
  Cost-effectiveness analysis based on a Markov model: Safety and effectiveness data of ticagrelor were obtained from a systematic review of the literature. Costs are expressed in Chilean pesos (CLP) as of 2013. The evaluation was conducted from the payer standpoint. A probabilistic sensitivity analysis comprising discount rates and national cost variability was done. A budget impact analysis estimated for 2015 was conducted to calculate the total cost for both treatments.
  
  
  RESULTS
  The ICER with a discount rate of 6% for ticagrelor vs. clopidogrel was CLP 4,893,126 per quality-adjusted life-year (QALY) gained (=9,689 US$). In the budget impact analysis for the baseline scenario, considering 100% of treatment, coverage, and adherence, ticagrelor represented an additional cost of CLP 5,233,854,272, for 979 QALYs gained compared with clopidogrel.
  
  
  CONCLUSIONS
  Ticagrelor is cost-effective in comparison with clopidogrel for the secondary prevention of acute coronary syndrome. These findings are similar to those reported in other international cost-effectiveness studies.
authors.affiliation: Centro de Excelencia CIGES, Universidad de La Frontera, Montt 112, Temuco 4781176, Chile. Electronic address: catherine.delapuente@gmail.com.
authors.forename: Catherine
authors.initials: C
authors.lastname: De la Puente
authors.affiliation: Centro de Excelencia CIGES, Universidad de La Frontera, Montt 112, Temuco 4781176, Chile.
authors.forename: Carlos
authors.initials: C
authors.lastname: Vallejos
authors.affiliation: Centro de Excelencia CIGES, Universidad de La Frontera, Montt 112, Temuco 4781176, Chile.
authors.forename: Luis
authors.initials: L
authors.lastname: Bustos
authors.affiliation: Centro de Excelencia CIGES, Universidad de La Frontera, Montt 112, Temuco 4781176, Chile; Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidad de La Frontera, Avenue Francisco salazar 01145, Temuco 4811230, Chile.
authors.forename: Carlos
authors.initials: C
authors.lastname: Zaror
authors.affiliation: Centro de Excelencia CIGES, Universidad de La Frontera, Montt 112, Temuco 4781176, Chile.
authors.forename: Monica
authors.initials: M
authors.lastname: Velasquez
authors.affiliation: Centro de Excelencia CIGES, Universidad de La Frontera, Montt 112, Temuco 4781176, Chile.
authors.forename: Fernando
authors.initials: F
authors.lastname: Lanas
mesh_terms: D054058:Acute Coronary Syndrome / Q000517:prevention & control*; D000241:Adenosine / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D000368:Aged; D000077144:Clopidogrel; D003362:Cost-Benefit Analysis / Q000191:economics*; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D007843:Latin America; D008297:Male; D008875:Middle Aged; D058921:Purinergic P2Y Receptor Antagonists / Q000191:economics / Q000627:therapeutic use; 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; Cost-utility; Myocardial infarction; Ticagrelor