OBJECTIVES

: Despite advances in management, Acute Coronary Syndrome (ACS) is still a major cause of mortality, morbidity and loss of disability-adjusted life years (DALYs). Antiplatelet therapy plays an important role in management of ACS. Among available approved medicines, Clopidogrel has been used widely in both local and international settings. However faced with some limitations such as higher risk of vascular ischemic complications and treatment resistance, Ticagrelor, a newer option from this class, has been approved to be used in ACS patients. The aim of present research is to determine the cost-effectiveness of Ticagrelor in comparison to Clopidogrel in Iranian ACS patients.

METHODS

: Target population of this study was ACS patients with mean age of 61. 25% of patients were women, which was comparable with Iranian ACS patients. This economic evaluation analysis was based on a one year decision tree model in payer perspective. The clinical efficacy and safety data was extracted from PLATO trial; however we used local direct costs based on official tariffs in Iran’s public and private sectors. In base case analysis, the price of original brand of Ticagrelor and Clopidogrel were included in model; however the generic and average market price of Clopidogrel were considered in our scenario analysis.

RESULTS : Compared with original branded Clopidogrel, treatment of Iranian ACS patients with Ticagrelor for one year would result in estimated more cost of 7639.74 US$ per patient. In the other hand, Ticagrelor could lead to averagely 1.4 death prevention in a cohort of 1000 patients. Accordingly, the estimated ICER for this analysis is 6052.87 US$ per one more death prevented. The calculated ICER for our scenario analysis using the generic and average market price of Clopidogrel are 9837.63 And 13054.05 US$/one death prevented, respectively.

CONCLUSIONS

: Ticagrelor is a Cost Effective Antiplatelet Medicine Compared with Clopidogrel in Iranian Patients with Acute Coronary Syndrome.