@article{10.11648/j.hep.20200503.13,
  author = {David Bin-Chia Wu and June Wai Yee Choon and Chun Wie Chong and Benjamin Shing Cheung Lee and Kenneth Kwing Chin Lee},
  title = {Economic Evaluation of Ticagrelor in Treating Patients with Acute Coronary Syndrome in Hong Kong: A Cost-Utility Analysis},
  journal = {International Journal of Health Economics and Policy},
  volume = {5},
  number = {3},
  pages = {63-71},
  doi = {10.11648/j.hep.20200503.13},
  url = {https://doi.org/10.11648/j.hep.20200503.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.hep.20200503.13},
  abstract = {This study aimed to evaluate the long-term cost-effectiveness of ticagrelor plus aspirin versus generic clopidogrel plus aspirin in acute coronary syndrome patients in Hong Kong (HK) from a public hospital’s perspective. The study has adapted a previously developed two-component prediction model. The first component is a simple decision tree corresponding to the first year. Afterwards events in the second year onwards were estimated using a state-transition Markov model incorporating the potential of recurrent events such as myocardial infarction and strokes that could lead to death for estimating the long-term economic and health outcomes measured as cost per quality-adjusted life year (QALYs). Kaplan Meier survival analysis was employed to determine the risk of events. Probabilistic sensitivity analysis was used to estimate the probability of ticagrelor being cost-effective. A cost-effectiveness acceptability curve was used to estimate the willingness-to-pay of patients. The use of ticagrelor led to improved clinical outcomes by gaining additional life-years and QALYS over 5-year and lifetime time horizons. The incremental cost-effectiveness ratio was above 1 Gross Domestic Product (GDP) per capita only for the 1-year results. By replacing clopidogrel with ticagrelor for life-time, the incremental drug costs were offset by the substantial reduction in other direct costs, leading to an overall cost-savings of HK 2,878 per patient. The probabilistic sensitivity analysis showed that ticagrelor has 53.5% chance of being dominant and 34.7% being cost-effective at a threshold of 1 GDP per capita for Hong Kong. A cost-effectiveness acceptability curve also showed that the willingness-to-pay for ticagrelor was 90% at 1 GDP per capita. Ticagrelor plus aspirin appeared to be cost-effective over 5-year and life-time projection periods compared to clopidogrel plus aspirin.},
 year = {2020}
}

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TY  - JOUR
T1  - Economic Evaluation of Ticagrelor in Treating Patients with Acute Coronary Syndrome in Hong Kong: A Cost-Utility Analysis
AU  - David Bin-Chia Wu
AU  - June Wai Yee Choon
AU  - Chun Wie Chong
AU  - Benjamin Shing Cheung Lee
AU  - Kenneth Kwing Chin Lee
Y1  - 2020/10/17
PY  - 2020
N1  - https://doi.org/10.11648/j.hep.20200503.13
DO  - 10.11648/j.hep.20200503.13
T2  - International Journal of Health Economics and Policy
JF  - International Journal of Health Economics and Policy
JO  - International Journal of Health Economics and Policy
SP  - 63
EP  - 71
PB  - Science Publishing Group
SN  - 2578-9309
UR  - https://doi.org/10.11648/j.hep.20200503.13
AB  - This study aimed to evaluate the long-term cost-effectiveness of ticagrelor plus aspirin versus generic clopidogrel plus aspirin in acute coronary syndrome patients in Hong Kong (HK) from a public hospital’s perspective. The study has adapted a previously developed two-component prediction model. The first component is a simple decision tree corresponding to the first year. Afterwards events in the second year onwards were estimated using a state-transition Markov model incorporating the potential of recurrent events such as myocardial infarction and strokes that could lead to death for estimating the long-term economic and health outcomes measured as cost per quality-adjusted life year (QALYs). Kaplan Meier survival analysis was employed to determine the risk of events. Probabilistic sensitivity analysis was used to estimate the probability of ticagrelor being cost-effective. A cost-effectiveness acceptability curve was used to estimate the willingness-to-pay of patients. The use of ticagrelor led to improved clinical outcomes by gaining additional life-years and QALYS over 5-year and lifetime time horizons. The incremental cost-effectiveness ratio was above 1 Gross Domestic Product (GDP) per capita only for the 1-year results. By replacing clopidogrel with ticagrelor for life-time, the incremental drug costs were offset by the substantial reduction in other direct costs, leading to an overall cost-savings of HK 2,878 per patient. The probabilistic sensitivity analysis showed that ticagrelor has 53.5% chance of being dominant and 34.7% being cost-effective at a threshold of 1 GDP per capita for Hong Kong. A cost-effectiveness acceptability curve also showed that the willingness-to-pay for ticagrelor was 90% at 1 GDP per capita. Ticagrelor plus aspirin appeared to be cost-effective over 5-year and life-time projection periods compared to clopidogrel plus aspirin.
VL  - 5
IS  - 3
ER  - 

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