Cost-Effectiveness of Clopidogrel plus Aspirin versus Aspirin Alone

Letters20 September 2005Cost-Effectiveness of Clopidogrel plus Aspirin versus Aspirin AloneMichael Rothberg, MD, MPHMichael Rothberg, MD, MPHFrom Baystate Medical Center, Springfield, MA 01108.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-143-6-200509200-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:As Schleinitz and Heidenreich pointed out (1), their finding that combination antiplatelet therapy with clopidogrel and aspirin in the first year following an acute coronary syndrome “represents good value according to traditional limits of cost-effectiveness” has serious economic implications if adopted into practice. Although decision analytic models offer valuable insight into treatment decisions, such as the observation that the first month of treatment is much more cost-effective than subsequent months, the simplifying assumptions required for modeling can lead to biased conclusions when comparing the cost-effectiveness of an intervention with an external benchmark. Before making treatment or policy ...References1. Schleinitz MD, Heidenreich PA. A cost-effectiveness analysis of combination antiplatelet therapy for high-risk acute coronary syndromes: clopidogrel plus aspirin versus aspirin alone. Ann Intern Med. 2005;142:251-9. [PMID: 15710958] LinkGoogle Scholar2. Yusuf S, Zhao F, Mehta SR, Chrolavicius S, Tognoni G, Fox KK, et al. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med. 2001;345:494-502. [PMID: 11519503] CrossrefMedlineGoogle Scholar3. Hurlen M, Abdelnoor M, Smith P, Erikssen J, Arnesen H. Warfarin, aspirin, or both after myocardial infarction. N Engl J Med. 2002;347:969-74. [PMID: 12324552] CrossrefMedlineGoogle Scholar4. Effects of long-term, moderate-intensity oral anticoagulation in addition to aspirin in unstable angina. The Organization to Assess Strategies for Ischemic Syndromes (OASIS) Investigators. J Am Coll Cardiol. 2001;37:475-84. [PMID: 11216966] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Baystate Medical Center, Springfield, MA 01108.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoA Cost-Effectiveness Analysis of Combination Antiplatelet Therapy for High-Risk Acute Coronary Syndromes: Clopidogrel plus Aspirin versus Aspirin Alone Mark D. Schleinitz and Paul A. Heidenreich Cost-Effectiveness of Clopidogrel plus Aspirin versus Aspirin Alone Peter Eriksson Cost-Effectiveness of Clopidogrel plus Aspirin versus Aspirin Alone Mark D. Schleinitz and Paul A. Heidenreich Metrics Cited ByMolecular mechanism of action for reversible P2Y12 antagonistsIncremental Effect of Clopidogrel on Important??Outcomes in Patients with Cardiovascular Disease 20 September 2005Volume 143, Issue 6Page: 464KeywordsConflicts of interestDecision makingMyocardial infarctionStatistical dataUnstable angina ePublished: 20 September 2005 Issue Published: 20 September 2005 CopyrightCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...