Sicras-Mainar A, Escobar-Cervantes C, Micó-Pérez R M, Llisterri-Caro J L
Dirección Científica, HEOR, Real Life Data, Madrid, España.
Servicio de Cardiología, Hospital Universitario La Paz, Madrid, España.
Semergen. 2020 Jan-Feb;46(1):16-26. doi: 10.1016/j.semerg.2019.05.004. Epub 2019 Jul 22.
To evaluate the adherence to treatment, resource use, and costs in subjects initiating treatment with brand-name versus generic clopidogrel for acute coronary syndrome (ACS) and peripheral arterial disease (PAD).
Observational, retrospective study based on the medical records of patients aged ≥18 years who initiated treatment with clopidogrel (brand-name vs. generic) between 4 April 2015 and 31 March 2017. Four study groups were compared, and the follow-up was one year. The main measurements were: comorbidity, treatment adherence, medication possession ratio (MPR), resource use, and costs. The results were analysed using multivariate analysis. The level of statistical significance was P<.05.
Four groups were compared: a) ACS: brand-name clopidogrel (N=1,067) vs. generic (N=3,504), and b) PAD: brand-name clopidogrel (N=425) vs. generic (N=994). In the ACS comparison (mean age: 69.7 years, 61.4% male), adherence (65.3% vs. 61.0%, P<.001), adjusted hazard ratio 0.85 and MPR (89.8% vs. 86.7%, P=.045) were more superior with brand-name clopidogrel than with the generic and with a lower mean cost per unit (€2,890 vs. €3,865, P=.001). In the PAD comparison, similar results were observed: persistence (64.7% vs. 58.9%, P=.039); adjusted hazard-ratio 0.86 and MPR (88.6% vs. 81.7%; P=.013) were more superior with brand-name clopidogrel than for the generic, with a lower mean cost per unit (€2,880 vs. €3,532, P=.044).
There was better treatment adherence in patients initiating treatment with brand-name compared with generic clopidogrel for ACS and PAD, resulting in lower health costs for the Spanish National Health System.
评估使用品牌氯吡格雷与通用氯吡格雷治疗急性冠状动脉综合征（ACS）和外周动脉疾病（PAD）的患者的治疗依从性、资源使用情况和成本。
基于2015年4月4日至2017年3月31日期间开始使用氯吡格雷（品牌与通用）治疗的≥18岁患者的病历进行观察性回顾性研究。比较了四个研究组，随访时间为一年。主要测量指标包括：合并症、治疗依从性、药物持有率（MPR）、资源使用情况和成本。使用多变量分析对结果进行分析。统计学显著性水平为P<0.05。
比较了四组：a）ACS：品牌氯吡格雷（N=1067）与通用氯吡格雷（N=3504），以及b）PAD：品牌氯吡格雷（N=425）与通用氯吡格雷（N=994）。在ACS组比较中（平均年龄：69.7岁，男性占61.4%），品牌氯吡格雷的依从性（65.3%对61.0%，P<0.001）、调整后的风险比0.85和MPR（89.8%对86.7%，P=0.045）均优于通用氯吡格雷，且单位平均成本更低（2890欧元对3865欧元，P=0.001）。在PAD组比较中，观察到类似结果：持续性（64.7%对58.9%，P=0.039）；品牌氯吡格雷的调整后风险比0.86和MPR（88.6%对81.7%；P=0.
