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07:45
Acute Myocardial Infarction in Rats
Published on: February 16, 2011
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Ticagrelor Use in Acute Myocardial Infarction: Balancing Evidence-Based Medicine with Affordability
Andrew L Walker1, Teshia Sorensen2, Paolo P Gabriel3
1University of Utah School of Medicine, Department of Internal Medicine, Salt Lake City, USA.
Journal of the American College of Clinical Pharmacy : JACCP
|January 15, 2019
Summary
High out-of-pocket costs for ticagrelor led to nearly half of acute myocardial infarction patients switching to clopidogrel after discussing medication expenses with a pharmacist.
Area of Science:
- Cardiology
- Pharmacoeconomics
- Health Services Research
Background:
- Randomized controlled trials demonstrate a mortality benefit for ticagrelor over clopidogrel in acute myocardial infarction (AMI) patients.
- Ticagrelor is frequently the preferred treatment for AMI patients by healthcare providers.
- Patient adherence to prescribed medication can be significantly influenced by out-of-pocket expenses.
Purpose of the Study:
- To investigate the association between out-of-pocket drug costs and the decision to continue ticagrelor versus switching to clopidogrel.
- To evaluate this association among patients hospitalized for AMI after a pharmacist-led discussion on ticagrelor co-payment costs.
Main Methods:
- Retrospective cohort study conducted at a tertiary care academic medical center.
- Included patients hospitalized with AMI between February 15, 2015, and January 23, 2017, who initially received ticagrelor.
- Analyzed patient data following a pharmacist-led discussion regarding outpatient co-payment costs for ticagrelor.
Main Results:
- Of 143 AMI patients initiated on ticagrelor, 70 (49%) switched to clopidogrel post-cost discussion.
- Median monthly ticagrelor co-payment was significantly higher for switchers ($268.29) compared to non-switchers ($18) (p<0.001).
- Patients with co-payments ≥$100/month were 3.4 times more likely to switch to clopidogrel.
Conclusions:
- A pharmacist-led discussion about outpatient medication costs prompted nearly half of AMI patients to switch from ticagrelor to clopidogrel.
- High out-of-pocket costs for ticagrelor are a significant factor influencing treatment choices in AMI patients.
- Cost-saving strategies, including medication cost discussions, are crucial for maintaining patient adherence to guideline-directed therapy.
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