OBJECTIVES : A new, pharmaceutical lipid-aspirin complex (PL-ASA) formulation has been specifically developed to reduce the risk of aspirin-induced gastric injury. In clinical studies PL-ASA liquid-filled capsules were shown to have significantly higher rates of complete aspirin response compared with the current standard of care (enteric coated aspirin tablets [EC-ASA]). Aspirin response has been linked to avoidance of ischemic events such as myocardial infarction MI) or stroke. In the current analysis we sought to determine the economic impact of switching patients from EC-ASA to PL-ASA for the first year following an index MI or stroke.

METHODS : We derived observed population size, rates of events, outcomes, and costs of care from existing literature and PL-ASA clinical trials for a hypothetical US health plan cohort of patients discharged from hospital after MI or stroke. We created a decision tree for the year post-discharge to determine the economic impact of switching all patients from EC-ASA to PL-ASA.

RESULTS : For a hypothetical US plan with 1 million members, an estimated 7422 patients will be discharged annually following an index MI or stroke. Compared to EC-ASA use, switching to PL-ASA would result in higher rates of aspirin response and fewer recurrent MI (70 less) and strokes (40 less). At the projected price of $0.85/day, the use of PL-ASA for secondary prevention resulted in overall cost savings of approximately $3.5 million in the first year after the index event. With an annual incidence of more than 1.5 million MI and strokes in the US, using PL-ASA instead of EC-ASA would result in annual cost savings in excess of $1 billion.

CONCLUSIONS : Adopting PL-ASA as the new standard of care after an acute CV event can result in significant clinical benefits for patients and substantial savings in the overall costs of care.