OBJECTIVES : To evaluate the economics of clopidogrel in antiplatelet therapy guided by CYP2C19 gene detection in patients with coronary heart disease.

METHODS : Using retrospective analysis, 247 inpatients with coronary heart disease treated with clopidogrel for antiplatelet therapy in our hospital from January to December 2017 were selected. According to whether the CYP2C19 gene test is performed or not, those patients were not randomly divided into gene testing group and conventional treatment group where standard dosage of clopidogrel were adopted. The cost only refers to direct medical costs, patients’ readmission rate within 1 year as the effectiveness. Incremental cost-effectiveness analysis and sensitivity analysis are performed.

RESULTS : The per capita total treatment cost of the gene test group (n = 123) was 47406.5 yuan, and the conventional treatment group (n = 124) was 31905.99 yuan, their difference was statistically significant (P<0.05); the readmission rate within 1 year was 13.01% in the gene test group, 28.22% in the conventional treatment group, their difference was significant (P<0.001). The incremental cost-effectiveness ratio is -1019.10 yuan per percent. Compared with the conventional treatment group, the genetic testing group costs 101910 yuan more for reducing one additional patient readmitted. In the sensitivity analysis, the genetic testing group has a cost-effective advantage only when the total per capita treatment cost of the genetic testing group is reduced by 30%.

CONCLUSIONS : Antiplatelet therapy of clopidogrel guided by CYP2C19 gene detection have showed a good effectiveness on preventing adverse cardiovascular events after percutaneous coronary intervention (PCI) in patients with coronary heart disease, but it is not economical. Economy can be achieved by reducing medical costs in the future.