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document
Cost-effectiveness of clopidogrel in acute coronary syndromes in Canada : a long-term analysis based on the CURE trial . BACKGROUND Cardiovascular diseases account for nearly 20 % of all hospitalizations in Canada and consume 12 % of the total cost of all illnesses . With increasing trends of cardiovascular disease and increasing costs of care , development of cost-effective strategies is vital . The Clopidogrel in Unstable angina to prevent Recurrent Events ( CURE ) trial demonstrated the effectiveness of clopidogrel plus acetylsalicylic acid ( ASA ) compared with ASA alone in reducing cardiovascular events in patients with acute coronary syndromes and , in addition , patients undergoing percutaneous coronary intervention in the Percutaneous Coronary Intervention in CURE ( PCI-CURE ) trial . OBJECTIVE To assess the cost-effectiveness of clopidogrel in the Canadian health care system . METHODS Estimates of hospitalization costs were based on the 2003 cost schedules released by the Health Funding and Costing Branch of the Alberta Health and Wellness , as well as on the Case Mix Group classification system . Life expectancy beyond the trial was estimated from the Saskatchewan Health Database . Cost-effectiveness was expressed as the incremental cost-effectiveness ratio , and bootstrap methods were used to estimate the joint distribution of costs and effectiveness . RESULTS Clopidogrel was shown to be cost-effective , with incremental cost-effectiveness ratios less than $ 10,000 per event prevented and less than $ 4,000 per life-year gained . The probability of clopidogrel resulting in cost per life-year gained of less than $ 20,000 was 0.975 for CURE patients and 0.904 for PCI-CURE patients . CONCLUSIONS The economic analysis demonstrated that clopidogrel combination therapy is not only cost-effective as antiplatelet therapy compared with ASA alone , but it is also cost-effective compared with other commonly used and openly reimbursed cardiovascular therapies in the Canadian health care system .
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Intervention_Pharmacological
clopidogrel
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Intervention_Pharmacological
Clopidogrel
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Intervention_Pharmacological
clopidogrel plus acetylsalicylic acid ( ASA )
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Intervention_Pharmacological
ASA alone
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Intervention_Pharmacological
clopidogrel
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Intervention_Pharmacological
Clopidogrel
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Intervention_Pharmacological
clopidogrel combination therapy
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Intervention_Control
ASA
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Outcome_Other
cost-effective
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Outcome_Other
cost-effectiveness ratios
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Outcome_Other
gained .
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Outcome_Other
cost per life-year gained
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Participant_Condition
acute coronary syndromes
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Participant_Condition
coronary intervention