Economic modelling of antiplatelet therapy in the secondary prevention of stroke

Summary

We used a UK-based health economics model to focus on preventative treatment in patients surviving acute stroke-related events. The health state transition model considered clinical recurrent events based on non-fatal transient ischaemic attacks, non-fatal other vascular events, and further acute strokes. Treatment was compared based on modified-release (MR) single agent dipyridamole, MR dipyridamole in combination with aspirin (Asasantin® Retard), low-dose aspirin (ASA), clopidogrel (Plavix®*), and placebo.

Asasantin® Retard is a registered trademark of Boehringer Ingelheim, UK; Plavix® is a registered trademark of Sanofi-Aventis, UK.

Resource use and unit cost data were based on a survey of dUK-based clinicians and standard national cost sources for 2002. Compared to aspirin, Asasantin Retard was associated with 29 fewer strokes over a 5-year period for every 1,000 patients treated, at an additional cost per treated patient of £64. This equated to a cost per avoided stroke of £2,255, and cost per life year gained of £5,103. Overall, the analysis suggests that Asasantin Retard provides additional benefits over aspirin, and has a favourable cost-effectiveness profile.

Key words: :

• stroke
• antiplatelet
• economic
• model
• cost-effectiveness
• dipyridamole
• UK