Cost–effectiveness of ticagrelor in acute coronary syndromes

Abstract

Ticagrelor is a reversibly binding oral P2Y₁₂ inhibitor, which belongs to a novel chemical class of antiplatelet agents named cyclopentyl-triazolo-pyrimidines. Ticagrelor administered with acetylsalicylic acid has been shown to reduce the rate of the composite end point of death from vascular causes, myocardial infarction or stroke without an increase in the rate of overall major bleeding compared with clopidogrel plus acetylsalicylic acid in patients with acute coronary syndromes. In addition to these clinical findings, it has been shown that the cost per quality-adjusted life year with ticagrelor is below the generally acceptable thresholds for cost–effectiveness compared with clopidogrel. Healthcare decision-makers need to consider the costs and cost–effectiveness when prioritizing treatments among scarce healthcare resources. This is of particular importance in cases similar to ticagrelor, where the novel treatment is expected to improve effectiveness at a higher acquisition cost. In this article, the authors review and discuss the health–economic evidence of ticagrelor.

Keywords::

• acute coronary syndromes
• cost–effectiveness
• oral antiplatelet therapy
• quality-adjusted life years
• ticagrelor

Financial & competing interests disclosure

M Henriksson and M Janzon were involved in the PLATO health–economic substudy through their affiliation with Linköping University (Linköping, Sweden). M Henriksson is an employee of AstraZeneca. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.