Presentation (CTI)

OBJECTIVES: Antiplatelet therapy is the cornerstone in the treatment of acute coronary syndrome. However, the economic evidence of these drugs remains limited in India. Hence, this study aimed to conduct a comparison of the cost-effectiveness of ticagrelor and prasugrel in patients with ACS undergoing Percutaneous coronary intervention.
METHODS: An economic model comprising a short-term decision tree and a long-term Markov model was developed to compare the cost-effectiveness of ticagrelor and prasugrel with a lifetime horizon from healthcare and societal perspectives. Clinical data for the model were taken from The Intracoronary Stenting and Antithrombotic Regimen: Rapid Early Action for Coronary Treatment (ISAR-REACT) 5 trial (2019). Variability in the model was assessed using one-way and probabilistic sensitivity analyses.
RESULTS: The preliminary analysis reported that prasugrel was associated with lower costs and higher effectiveness, placing it in the Southeast quadrant and highlighting its dominance in the Indian healthcare setting. Prasugrel was the preferred choice in all the iterations in the probabilistic sensitivity analysis. However, these results are subject to refinement and revision after further validation and scenario analysis.
CONCLUSIONS: Prasugrel treatment resulted in lower costs and higher effectiveness than ticagrelor. This antiplatelet agent merits further evaluation in the Indian healthcare setting owing to its potential clinical and economic relevance within a resource-constrained healthcare system.