Fitria Najmiatul, Febiana Dian, Akram Muhammad, Yosmar Rahmi
Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Andalas, Padang, Indonesia.
Faculty of Pharmacy, Universitas Andalas, Padang, Indonesia.
Narra J. 2024 Aug;4(2):e758. doi: 10.52225/narra.v4i2.758. Epub 2024 Jun 19.
Understanding the cost-effectiveness of aspirin-clopidogrel combination therapy is crucial in determining its influence on coagulation parameters, specifically prothrombin time (PT) and activated partial thromboplastin time (APTT). The aim of this study was to assess the cost-effectiveness and clinical impact of using the aspirin-clopidogrel combination compared to aspirin alone in managing ischemic stroke. Employing an observational research design, inpatient ischemic stroke cases receiving the aspirin-clopidogrel combination were compared to those treated with aspirin alone. Focusing on the hospital's perspective on costs, the research specifically analyzed medical expenses without discounting costs or effects. The analysis involved comparing the direct medical costs and coagulation parameters between the two treatment groups. Our data revealed that the aspirin-clopidogrel combination demonstrated superior cost-effectiveness over aspirin alone, indicated by the incremental cost-effectiveness ratio (ICER) values for PT (IDR -246,930/second) and APTT (IDR -119,270/second). This indicated that the combination therapy was associated with lower costs while yielding better clinical parameter values. The ICER analysis placed the aspirin-clopidogrel combination in the southeast quadrant, marking its dominance over aspirin monotherapy by demonstrating higher effectiveness at lower costs. These results suggest that combination therapy might be a favorable alternative for managing ischemic stroke, presenting a viable option for consideration in clinical practice. The findings underscore the potential economic and clinical advantages of employing the aspirin-clopidogrel combination in routine stroke management protocols.
了解阿司匹林 - 氯吡格雷联合疗法的成本效益对于确定其对凝血参数的影响至关重要，特别是凝血酶原时间（PT）和活化部分凝血活酶时间（APTT）。本研究的目的是评估与单独使用阿司匹林相比，使用阿司匹林 - 氯吡格雷联合疗法治疗缺血性中风的成本效益和临床影响。采用观察性研究设计，将接受阿司匹林 - 氯吡格雷联合疗法的住院缺血性中风病例与单独使用阿司匹林治疗的病例进行比较。从医院对成本的角度出发，该研究特别分析了医疗费用，未对成本或效果进行贴现。分析涉及比较两个治疗组之间的直接医疗成本和凝血参数。我们的数据显示，阿司匹林 - 氯吡格雷联合疗法的成本效益优于单独使用阿司匹林，PT的增量成本效益比（ICER）值为（-246,930印尼盾/秒），APTT为（-119,270印尼盾/秒）。这表明联合疗法在成本较低的情况下能产生更好的临床参数值。ICER分析将阿司匹林 - 氯吡格雷联合疗法置于东南象限，通过以较低成本显示出更高的有效性，表明其优于阿司匹林单药治疗。这些结果表明，联合疗法可能是治疗缺血性中风的一个有利选择，是临床实践中值得考虑的一个可行方案。研究结果强调了在常规中风管理方案中采用阿司匹林 - 氯吡格雷联合疗法的潜在经济和临床优势。
