急性冠状动脉综合征患者PCI术后抗血小板治疗的药物经济学评价

Pharmacoeconomic Evaluation of Antiplatelet Therapy in Patients with Acute Coronary Syndrome after PCI

目的:从医疗服务角度,对急性冠状动脉综合征(ACS)患者行经皮冠状动脉介入治疗(PCI)术后两种抗血小板药物治疗方案进行经济学评价。方法:两种治疗方案为在使用阿司匹林基础上,经验性给予国产氯吡格雷,或经验性给予替格瑞洛,由此建立决策树及Markov模型并进行成本-效果分析,评价中国ACS患者PCI术后使用氯吡格雷和替格瑞洛的成本-效果。结果:经验性给予国产氯吡格雷联合阿司匹林治疗方案为成本最低方案,但直接给予替格瑞洛联合阿司匹林治疗方案具有较好的成本-效果。结论:对于PCI术后的ACS患者抗血小板治疗,最推荐直接采用替格瑞洛联合阿司匹林的治疗方案。

Objective:From the perspective of medical services,the economic evaluation of two anti-platelet drug treatment options after percutaneous coronary intervention(PCI)in patients with acute coronary syndromes.Methods:Two treatment options were based on the use of aspirin,empirically given domestic clopidogrel,or empirically given ticagrelor.Based on this,a decision tree and Markov model were established and cost-effectiveness analysis was performed to evaluate the use of clopidogrel in Chinese ACS patients and cost effectiveness of tigrelor.Results:Empirically giving domestic clopidogrel combined with aspirin was the lowest cost option,but direct administration of ticagrelor plus aspirin had a better cost-effectiveness.Conclusion:For antiplatelet therapy in patients with ACS after PCI,it is most recommended to use ticagrelor plus aspirin directly.