Details

Autor(en) / Beteiligte

• Tsaban, Gal
• Alnsasra, Hilmi
• El Nasasra, Aref
• Abu-Salman, Amjad
• Abu-Dogosh, Ala
• Weissberg, Itay
• Golan, Yael Ben-Baruch
• Barrett, Orit
• Westreich, Roi
• Aboalhasan, Enis
• Azuri, Joseph
• Hammerman, Ariel
• Arbel, Ronen

Titel

Aspirin with Low-Dose Ticagrelor or with Low-Dose Rivaroxaban for Secondary Prevention: A Cost per Outcome Analysis

Ist Teil von

• American journal of cardiovascular drugs : drugs, devices, and other interventions, 2022-11, Vol.22 (6), p.677-683

Ort / Verlag

Cham: Springer International Publishing

Erscheinungsjahr

2022

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Introduction Secondary prevention of cardiovascular events among patients with diagnosed cardiovascular disease and high ischemic risk poses a significant challenge in clinical practice. The combinations of aspirin with low-dose (LD) ticagrelor or LD rivaroxaban have shown superiority in preventing major adverse cardiovascular events (MACE) compared with aspirin treatment alone. The comparative value for money of these two regimens remains unexplored. Methods We analyzed each regimen's annual cost needed to treat (CNT) by multiplying the annualized number needed to treat (aNNT) by the annual cost of each drug. The aNNTs were based on outcome data from PEGASUS TIMI-54 and COMPASS trials. Scenario analyses were performed to overcome variances in terms of population risk. Costs were calculated as 75% of US National Average Drug Acquisition Cost (NADAC), extracted in January 2022. The primary outcome was defined as CNT to prevent one MACE across the two regimens. Secondary value analysis was performed for myocardial infarction (MI), stroke, and cardiovascular death as separate outcomes. Results The aNNTs to prevent MACE with LD ticagrelor and with LD rivaroxaban were 229 [95% confidence interval (CI) 141–734] and 147 (95% CI 104–252), respectively. At an annual cost of US$3726 versus US$4533, the corresponding CNTs were US$853,254 (95% CI 525,366–2,734,884) with LD ticagrelor and US$666,351 (95% CI 471,432–1,142,316) with LD rivaroxaban. Conclusion Combining aspirin with LD rivaroxaban provides better value for money than with LD ticagrelor for secondary prevention of MACE.