Cost-Effectiveness of Clopidogrel plus Aspirin versus Aspirin Alone for Secondary Prevention of Cardiovascular Events- Results from the CHARISMA Trial

Sep 1, 2009, 00:00 AM
Section Title :
Section Order : 8
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To determine the incremental cost-effectiveness of clopidogrel plus aspirin (C + A) compared with aspirin (A) alone during the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance (CHARISMA) trial from a US payer perspective.


Although the CHARISMA trial did not find a benefit of adding clopidogrel to aspirin in its overall study cohort, a benefit was suggested in a prespecified subgroup of patients with established cardiovascular (CV) disease. The cost-effectiveness of dual antiplatelet therapy in this population is unknown.


Medical resource utilization was assessed prospectively, and costs for hospitalizations, physician services, outpatient care, and medications were assigned using 2007 US dollars. Life expectancy was estimated contingent on fatal and nonfatal CV events using statistical models of long-term survival from the Saskatchewan Health database.


C + A was associated with a 12.5% relative reduction in CV death, myocardial infarction, or stroke compared with A alone (6.9% vs. 7.9%, P = 0.048) over a median 28 months of follow-up. Severe or moderate bleeding events were higher in patients receiving C + A versus A alone (3.6% vs. 2.5%, P $100,000/life-year gained in 87.4%.


Among patients with established CV disease, adding clopidogrel to aspirin appears to increase life expectancy modestly at a cost generally considered acceptable within the US health-care system.
HEOR Topics :
  • Cardiovascular Disorders
  • Cost/Cost of Illness/Resource Use Studies
  • Cost-comparison, Effectiveness, Utility, Benefit Analysis
  • Economic Evaluation
  • Retrospective Databases: Electronic Medical and Health Records, Admin Claims
  • Specific Diseases & Conditions
  • Study Approaches
Tags :
  • aspirin
  • cardiovascular disease
  • clopidogrel
  • cost-effectiveness analysis
  • secondary prevention
Regions :
  • North America