In a lifetime horizon, which should be used when comparing technologies with different impacts on mortality, cost-effectiveness evaluation resulted in more favourable economic outcomes for ticagrelor than for generic clopidogrel, with the cost per QALY well below the recommended willingness to pay threshold in Poland (24,965 PLN vs. 111,381 PLN).
throughout the sensitivity analyses. CONCLUSIONS: Based on evidence from the PLATO study, treating a broad spectrum of ACS patients with ticagrelor for one year seems to offer a cost-effective option in the German health care setting compared with clopidogrel.
OBJECTIVES:We examined sponsorship of published economic evaluations of statin use for cardiovascular (CDV) prevention and evaluated whether funding is associated with study conclusions. METHODS: A systematic review was conducted in PubMed/MEDLINE (up to June 2011) to identify cost-effectiveness analyses of statin use for CDV prevention reporting outcomes as cost per life years gained and/or quality-adjusted life years. The review was restricted to 6 licensed statins: simvastatin, pravastatin, fluvastatin, lovastatin, atorvastatin and rosuvastatin. We classified study intervention data as follows: 1) comparators: statin-statin or statinnon active drug comparisons, and 2) primary or secondary CDV prevention. We established relationships between funding source (industry-vs. non-industrysponsored studies) and qualitative conclusions (favorable, unfavorable or neutral) by means tests of differences between proportions. RESULTS: Overall, 72 studies were included. Thirty-six studies (50%) were carried out in Europe and 31 (43%) in North America. Fourty-seven (65%) articles compared statins versus non-active drugs. The category of CDV prevention was distributed as follows: 46% secondary, 39% primary and 15% both. Considering funding source, 64% were industry-sponsored studies. For studies evaluating primary CDV prevention, industry-sponsorship was much less likely to have unfavorable or neutral conclusions (0% vs. 59%; pϽ0.001). Conversely, these differences were not detected for studies evaluating secondary CDV prevention (0% versus 13%; pϭ0.212). CONCLUSIONS: Our results suggest that sponsorship of economic evaluation of statins is associated with their qualitative conclusions in primary CDV prevention.
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