Die Langzeit-Kosteneffektivität von Clopidogrel zusätzlich zu Azetylsalizylsäure bei Patienten mit akutem Koronarsyndrom ohne ST-Streckenhebung im österreichischen Gesundheitssystem

Patients with acute coronary syndrome without ST-segment elevation receiving clopidogrel in addition to acetylsalicylic acid (ASA) showed a 20% risk reduction in comparison to patients receiving ASA monotherapy (CURE trial). Economic models for assessing the impact on costs exist for several countries but not for Germany on a long-term basis. The objective of this model adaptation is to assess the long-term economic impact of clopidogrel taken in addition to ASA in Germany. A Markov model with six states [at risk, first year with stroke, following years with stroke, first year with new myocardial infarction (MI), following years with MI, and death] was adapted for Germany. Model outcome was life-years saved. Effects of 1-year treatment were calculated based on the CURE trial. Resource use for the different health states was based on published data, which included costs for drugs, outpatient care, hospitalization, rehabilitation and nursing. Risk data for MI and stroke were based on Swedish data and validated for the German adaptation. The model calculates lifetime costs and survival length. Costs were estimated from the payers' perspective. A series of one-way sensitivity analyses was conducted (follow-up costs, discount rates). The Markov analysis predicts a survival of 8.89years in the placebo treatment group and 9.02 years in the clopidogrel treatment group. The cumulated costs were euro 8,548 and euro 8,953, respectively. The incremental cost-effectiveness ratio (ICER) was euro 3,113 for each life-year saved. The model was robust regarding variations in key parameters in the sensitivity analysis, resulting in a range of ICER from euro 1,338 to euro 9,322. Our results are in line with the results for other healthcare systems. Adding clopidogrel to ASA for patients with acute coronary syndrome without ST-segment elevation generated an additional life-year saved at a comparably low value of euro 3,113. One-year treatment with clopidogrel is a cost-effective treatment option in patients with acute coronary syndrome from the perspective of a third-party payer in Germany.

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“…The result of the [9,[18][19][20][21]. In Scandinavian countries, cost per LYS ranged from €549 to €4,003.…”

Section: Discussionmentioning

confidence: 99%

Long-term cost-effectiveness of clopidogrel in patients with acute coronary syndrome without ST-segment elevation in Germany

Brüggenjürgen

Lindgren²,

Ehlken³

et al. 2006

Eur J Health Econ

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Die Kosteneffektivität von Clopidogrel in der Behandlung des akuten Koronarsyndroms ohne ST-Streckenhebung — ein pharmakoökonomischer Review

Steinle¹,

Willich

Zeymer

2008

Pharmacoeconomics-Ger-Res-Articles

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Die Kosteneffektivität von Clopidogrel bei Patienten mit Atherosklerose-assoziierten Erkrankungen

Schwarz

Nanz²

2005

Pharmacoeconomics-Ger-Res-Articles

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Die Langzeit-Kosteneffektivität von Clopidogrel zusätzlich zu Azetylsalizylsäure bei Patienten mit akutem Koronarsyndrom ohne ST-Streckenhebung im österreichischen Gesundheitssystem

Cited by 7 publications

References 12 publications

Long-term cost-effectiveness of clopidogrel in patients with acute coronary syndrome without ST-segment elevation in Germany

Long-term cost-effectiveness of clopidogrel in patients with acute coronary syndrome without ST-segment elevation in Germany

Die Kosteneffektivität von Clopidogrel in der Behandlung des akuten Koronarsyndroms ohne ST-Streckenhebung — ein pharmakoökonomischer Review

Die Kosteneffektivität von Clopidogrel bei Patienten mit Atherosklerose-assoziierten Erkrankungen

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