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Cost-effectiveness of clopidogrel in patients with acute coronary syndrome undergoing percutaneous coronary
Saba Abidi1, Anoop Kumar2, Shridhar Dwivedi3
1School of Allied Health Sciences and Management, Delhi Pharmaceutical Sciences and Research University, New Delhi, India.
Insights
This review examines the cost-effectiveness of clopidogrel for acute coronary syndrome (ACS) patients after percutaneous coronary intervention (PCI). It compares clopidogrel against other antiplatelet drugs to inform treatment decisions.
Area of Science:
- Cardiovascular Medicine
- Health Economics
- Pharmacoeconomics
Background:
- Acute coronary syndrome (ACS) is a growing global health concern, leading to premature death and requiring costly interventions like percutaneous coronary intervention (PCI).
- Antiplatelet therapies, including clopidogrel, are vital for managing ACS patients post-PCI, aiming to prevent ischemic events and mortality.
- The rising incidence of ACS and the associated healthcare costs necessitate thorough economic evaluations of treatment strategies.
Purpose of the Study:
- To systematically review and assess the cost-effectiveness of clopidogrel compared to alternative antiplatelet drugs in patients with ACS undergoing PCI.
- To synthesize economic evidence regarding the value of clopidogrel in this patient population.
Main Methods:
- Adherence to JBI methodology for systematic reviews of economic evaluations.
- Systematic literature search and screening of records by two independent reviewers.
- Data extraction and methodological quality assessment using JBI guidelines.
- Application of the JBI Dominance Ranking Matrix for economic evaluations.
- Utilizing the GRADE approach to appraise the certainty of economic evidence.
Main Results:
- The review will summarize cost-effectiveness data, including incremental cost and cost per quality-adjusted life year (QALY) or disability-adjusted life year (DALY).
- Comparison of clopidogrel's economic value against other antiplatelet agents will be presented.
- Certainty of economic evidence will be assessed using the GRADE framework.
Conclusions:
- Findings will inform healthcare decision-making regarding the optimal use of clopidogrel in ACS patients post-PCI.
- The review aims to provide evidence-based insights into the economic value of clopidogrel in cardiovascular care.
- Results will contribute to resource allocation strategies in managing ACS.
Objective:
This systematic review will assess the cost-effectiveness of clopidogrel in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).
Introduction:
Antiplatelet drugs, including clopidogrel, ticagrelor, prasugrel, and aspirin, are crucial in managing ACS, preventing ischemia, and, ultimately, death in PCI patients. Clopidogrel is the main treatment for those who have undergone PCI, used either alone or with aspirin. The incidence of ACS is rising globally, and is a major cause of premature death for millions. ACS management involves continuous medical therapy and costly procedures such as PCI, significantly straining health care resources.
Eligibility Criteria:
Studies will be eligible for inclusion if they report on the cost-effectiveness of clopidogrel in patients with ACS compared with other antiplatelet drugs.
Methods:
This systematic review will adhere to the JBI methodology for systematic reviews of economic evaluation evidence. A preliminary search was conducted of MEDLINE (PubMed) using MeSH terms. Two independent reviewers will screen records at the title/abstract level, followed by full-text screening. Two reviewers will then assess methodological quality and extract data as per JBI guidelines. The JBI Dominance Ranking Matrix for economic evaluations will be used to summarize and compare the included studies. The cost-effectiveness measures will be incremental cost, incremental cost per quality-adjusted life year gained, or incremental cost per disability-adjusted life year averted. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach will be used to appraise the certainty of economic evidence, such as using resources and expenditure, for incorporating the results into the decision-making process.
Review Registration:
PROSPERO CRD42024504614.
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