TITLE

Cost-effectiveness analysis of ticagrelor, compared to clopidogrel, for the treatment of patients with acute coronary syndrome in Colombia

AUTHOR(S)
Mejía, Aurelio; Senior, Juan Manuel; Ceballos, Mateo; Atehortúa, Sara; Toro, Juan Manuel; Saldarriaga, Clara; Mejía, Maria Elena; Ramírez, Carolina
PUB. DATE
December 2015
SOURCE
Biomédica: Revista del Instituto Nacional de Salud;dic2015, Vol. 35 Issue 4, p2
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Introducción. El síndrome coronario agudo es una de las emergencias médicas más frecuentes en los países en desarrollo. Objetivo. Determinar, desde la perspectiva del sistema de salud colombiano, la relación de costo efectividad de ticagrelor comparado con clopidogrel para el tratamiento de pacientes con síndrome coronario agudo. Materiales y métodos. Análisis de costo efectividad desde la perspectiva del sistema de salud colombiano, comparando ticagrelor y clopidogrel para el tratamiento de pacientes con síndrome coronario agudo. Para estimar los costos y resultados esperados de las dos alternativas, se construyó un modelo de Markov en el cual los pacientes pueden permanecer estables sin experimentar nuevos eventos cardiovasculares, sufrir de un nuevo evento coronario o morir. Para el caso base, se adoptó un horizonte temporal de 10 años y una tasa de descuento de 3% para los costos y beneficios. Las probabilidades de transición fueron extraídas del ensayo clínico PLATO. Estadísticas vitales fueron extraídas del DANE y parámetros adicionales del modelo a partir de la información de los pacientes colombianos incluidos en el registro ACCESS. Para identificar y medir el uso de recursos, se construyó un caso estándar a partir de guías y protocolos. Los costos unitarios se obtuvieron de manuales tarifarios colombianos. Se realizó un análisis de sensibilidad probabilístico en el que los costos se representaron por una distribución triangular y las probabilidades de transición a través de una distribución beta. Resultados. En el caso base, el costo adicional por AVAC ganado con ticagrelor fue $28.411.503 COP. Los resultados fueron sensibles a los cambios en el horizonte temporal y al costo unitario de clopidogrel. Para un umbral de costo efectividad equivalente a tres veces el PIB per cápita de Colombia, la probabilidad de que ticagrelor sea costo efectivo es del 75%.Conclusiones: el ticagrelor es una estrategia costo-efectiva para el tratamiento de los pacientes con síndrome coronario agudo en Colombia.
ACCESSION #
110585648

 

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