Table 1. Model Parameters Used in Determining Cost-Effectiveness of Antiplatelet Therapy Selection.
Parameter | Base-Case Value (range) |
---|---|
UM or EM3, 6, 25–27, 29, 30 | 0.730 (0.680–0.738)a |
IM or PM4, 6, 26, 27 | 0.270 (0.261–0.319)a, b |
Cardiovascular event for UM or EM with clopidogrel3, 25, 26 | 0.080 (0.059–0.139) |
Noncardiovascular event (bleeding) for UM or EM with clopidogrel3 | 0.030 |
Cardiovascular event for IM or PM with prasugrel4 | 0.085 |
Noncardiovascular event (bleeding) for IM or PM with prasugrel4 | 0.045 |
Cardiovascular event with clopidogrel12, 28 | 0.121 (0.092–0.150)b |
Cardiovascular event with prasugrel12, 28 | 0.099 (0.057–0.141)b |
Noncardiovascular event (bleeding) with clopidogrel12, 28 | 0.038 (0.022–0.054)c |
Noncardiovascular event (bleeding) with prasugrel12, 28 | 0.050 (0.022–0.078)c |
Genotyping CYP2C1917, 18 | $310d |
Uncomplicated percutaneous coronary intervention19 | $18,000d |
Branded clopidogrel 75 mg/day for 15 mo20 | $2660d |
Prasugrel 10 mg/day for 15 mo20 | $2800d |
Bleeding event21 | $19,360 |
Cardiovascular death22 | $23,760d |
Nonfatal myocardialinfarction22 | $40,970d |
Nonfatal stroke22 | $27,314d |
Costs are reported in 2011 U.S. dollars.
Cardiovascular events were defined as a composite of cardiovascular deaths, nonfatal myocardial infarction, and nonfatal stroke. UM or EM = ultrarapid or extensive metabolizer; IM or PM = intermediate or poor metabolizer; CYP2C19 = cytochrome P450 2C19.
Values reflect IMs or PMs for predominantly Caucasian populations.
Value of lower range imputed from upper range.
Value of upper range imputed from lower range.
All costs reflect adjusted August 2011 costs discounted at 5% to account for future value.