Lee VW, Lau CC, Lau CS, Mo CL, Chan TY, The Chinese University of Hong Kong, Shatin, Hong Kong

OBJECTIVES: Clopidogrel is a new antiplatelet drug indicated for various cardiological and neurological conditions. However, its use is limited due to the high cost. In the year 2000/01, the total drug expenditure on clopidogrel (including both inpatient and outpatient uses) had risen from HK $ 300,000 (US$ 38,460) (1 US$=7.8 HK$) to HK$ 1 million (US $ 128,205) which was 0.5% of the total drug expenditure for 2002/03. The current study was conducted at the Prince of Wales Hospital (PWH), which is a local public teaching hospital in Hong Kong. The aims of the study were to examine the prescribing pattern of clopidogrel at PWH, to determine the side effect profile of clopidogrel in Chinese patients and to analyze its cost for outpatient uses. METHODS: It was a retrospective study performed in patients who were prescribed with clopidogrel from April 2000 to November 2002. Only discharge prescriptions from the cardiology and neurology wards and prescriptions from Specialty Out-Patient Clinic were studied. Data collected included demographic data, indications, dosage, treatment duration, treatment plan, and side effects. RESULTS: A random sample of 96 patients was studied. Approximately 94% of cases were found to be appropriately prescribed according to the guideline in PWH. Clopidogrel was prescribed to 88% of patients to whom percutaneous coronary intervention (PCI) was planned. Seven percent of the use was for secondary prevention of cerebral vascular accident (CVA). Nine percent of patients experienced side effects. Skin rash (3.6%) and minor bleeding (3.6%) were the most common ones. Most cost was attributed to patients who had undergone PCI (47.6%) and patients with CVA (46.5%). CONCLUSION: In this drug use evaluation, use of clopidogrel at PWH was in general appropriate. Clopidogrel was well tolerated.