Amirsadri Mohammadreza, Sedighi Mohammad Javad
Department of Clinical Pharmacy and Pharmacy Practice and Isfahan Pharmaceutical Sciences Research Center, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, I.R. Iran.
Res Pharm Sci. 2017 Apr;12(2):144-153. doi: 10.4103/1735-5362.202453.
Aspirin is one of the certified medicines commonly used for the secondary prevention of myocardial infarction (MI). Aspirin side effects and gastrointestinal bleeding, in particular, have arisen debates on its use for the primary prevention of MI. The present research evaluates the cost-effectiveness of the use of aspirin in the primary prevention of MI among Iranian men with average cardiovascular disease (CVD) risk, using Markov modeling technique. The incremental cost-effectiveness ratios (ICERs) estimated to be 864 USA dollars (USD) per quality-adjusted life years (QALY) gained and 782 USD per life years gained (LYG) for each patient in the base-case scenario (public tariffs and no discounting). This research proves cost-effectiveness of the use of aspirin in the primary prevention of MI in targeted population, since the assessed ICERs are quite under the recommended threshold by WHO which is one gross domestic product (GDP) per capita ($5315.1 for Iran in 2015).
阿司匹林是常用于心肌梗死（MI）二级预防的经认证药物之一。阿司匹林的副作用，尤其是胃肠道出血，引发了关于其用于MI一级预防的争论。本研究采用马尔可夫建模技术，评估了阿司匹林在心血管疾病（CVD）风险平均的伊朗男性中用于MI一级预防的成本效益。在基础案例情景（公共关税且无贴现）中，估计每获得一个质量调整生命年（QALY）的增量成本效益比（ICER）为864美元（USD），每位患者每获得一个生命年（LYG）的ICER为782美元（USD）。本研究证明了阿司匹林在目标人群中用于MI一级预防的成本效益，因为评估出的ICER远低于世界卫生组织推荐的阈值，即人均国内生产总值（2015年伊朗为5315.1美元）。
