Monica Velasquez

Latin American Clinical Epidemiology Network Series – Paper 8: Ticagrelor was cost-effective vs. clopidogrel in acute coronary syndrome in Chile

OBJECTIVE To evaluate the incremental cost-effectiveness ratio (ICER) of the use of ticagrelor as a substitute for clopidogrel for secondary prevention of acute coronary syndrome in Chile. STUDY DESIGN AND SETTING Cost-effectiveness analysis based on a Markov model: Safety and effectiveness data of ticagrelor were obtained from a systematic review of the literature. Costs are expressed in Chilean pesos (CLP) as of 2013. The evaluation was conducted from the payer standpoint. A probabilistic sensitivity analysis comprising discount rates and national cost variability was done. A budget impact analysis estimated for 2015 was conducted to calculate the total cost for both treatments. RESULTS The ICER with a discount rate of 6% for ticagrelor vs. clopidogrel was CLP 4,893,126 per quality-adjusted life-year (QALY) gained (=9,689 US

Series: the Latin American Clinical Epidemiology Network (LatinCLEN)Latin American Clinical Epidemiology Network Series – Paper 8: Ticagrelor was cost-effective vs. clopidogrel in acute coronary syndrome in Chile

). In the budget impact analysis for the baseline scenario, considering 100% of treatment, coverage, and adherence, ticagrelor represented an additional cost of CLP 5,233,854,272, for 979 QALYs gained compared with clopidogrel. CONCLUSIONS Ticagrelor is cost-effective in comparison with clopidogrel for the secondary prevention of acute coronary syndrome. These findings are similar to those reported in other international cost-effectiveness studies.

Ticagrelor was cost-effective vs. clopidogrel in acute coronary syndrome in Chile

OBJECTIVE To evaluate the incremental cost-effectiveness ratio (ICER) of the use of ticagrelor as a substitute for clopidogrel for secondary prevention of acute coronary syndrome in Chile. STUDY DESIGN AND SETTING Cost-effectiveness analysis based on a Markov model: Safety and effectiveness data of ticagrelor were obtained from a systematic review of the literature. Costs are expressed in Chilean pesos (CLP) as of 2013. The evaluation was conducted from the payer standpoint. A probabilistic sensitivity analysis comprising discount rates and national cost variability was done. A budget impact analysis estimated for 2015 was conducted to calculate the total cost for both treatments. RESULTS The ICER with a discount rate of 6% for ticagrelor vs. clopidogrel was CLP 4,893,126 per quality-adjusted life-year (QALY) gained (=9,689 US

Principales aspectos metodológicos en la Evaluación de Tecnologías Sanitarias

). In the budget impact analysis for the baseline scenario, considering 100% of treatment, coverage, and adherence, ticagrelor represented an additional cost of CLP 5,233,854,272, for 979 QALYs gained compared with clopidogrel. CONCLUSIONS Ticagrelor is cost-effective in comparison with clopidogrel for the secondary prevention of acute coronary syndrome. These findings are similar to those reported in other international cost-effectiveness studies.

Análisis Costo Efectividad del Stent Farmacológico V/S Stent no Farmacológico en Cardiopatía Isquémica en Chile

OBJECTIVE To evaluate the incremental cost-effectiveness ratio (ICER) of the use of ticagrelor as a substitute for clopidogrel for secondary prevention of acute coronary syndrome in Chile. STUDY DESIGN AND SETTING Cost-effectiveness analysis based on a Markov model: Safety and effectiveness data of ticagrelor were obtained from a systematic review of the literature. Costs are expressed in Chilean pesos (CLP) as of 2013. The evaluation was conducted from the payer standpoint. A probabilistic sensitivity analysis comprising discount rates and national cost variability was done. A budget impact analysis estimated for 2015 was conducted to calculate the total cost for both treatments. RESULTS The ICER with a discount rate of 6% for ticagrelor vs. clopidogrel was CLP 4,893,126 per quality-adjusted life-year (QALY) gained (=9,689 US

Apixaban was cost-effective vs. acenocoumarol in patients with nonvalvular atrial fibrillation with moderate to severe risk of embolism in Chile

). In the budget impact analysis for the baseline scenario, considering 100% of treatment, coverage, and adherence, ticagrelor represented an additional cost of CLP 5,233,854,272, for 979 QALYs gained compared with clopidogrel. CONCLUSIONS Ticagrelor is cost-effective in comparison with clopidogrel for the secondary prevention of acute coronary syndrome. These findings are similar to those reported in other international cost-effectiveness studies.

Revisión Sistemática sobre los Efectos Adversos de la Fluoración del Agua

This article reviews the most relevant methodological aspects involved in Health Technology Assessment (HTA). Firstly, it addresses the process of defining the research problem (or scoping). Then it explains some specific aspects of systematic reviews of evidence, as well as indirect and mixed comparisons of the effectiveness of interventions. It covers also the methods for economic evaluation in healthcare and the budget impact analysis of interventions. Finally, the paper provides an empirical insight on the methodological emphasis used by HTA agencies around the world, and reflects on the available capacities in our country in the topics discussed.This article reviews the most relevant methodological aspects involved in Health Technology Assessment (HTA). Firstly, it addresses the process of defi-ning the research problem (or scoping). Then it explains some specific aspects of systematic reviews of evidence, as well as indirect and mixed comparisons of the effectiveness of interventions. It covers also the methods for economic eva-luation in healthcare and the budget impact analysis of interventions. Finally, the paper provides an empirical insight on the methodological emphasis used by HTA agencies around the world, and reflects on the available capacities in our country in the topics discussed.(Rev Med Chile 2014; 142 (S1): S 16-21)

Cost-Effectiveness of Exercise-Based Cardiac Rehabilitation in Chilean Patients Surviving Acute Coronary Syndrome

OBJECTIVE To evaluate and compare the costs and effectiveness of two alternative stent, drug eluting stent (SF) and bare metal stent (SNF). MATERIAL AND METHODS Cost-utility analysis based on a Markov model using data from a cohort study of Hospital Las Higueras of Talcahuano, Chile. The effectiveness measure was the rate of restenosis and the time of restenosis. The effectiveness outcomes are expressed in quality-adjusted life years (QALY) gained. Costs are expressed in national currency 2011. The evaluation perspective was from the public heath budget. We model a cohort from age 63 to 80 years, life expectancy in Chile. Apply discount rate of 0, 3% and 6% for results and costs. Sensitivity analysis is performed according to the ranges of variability in costs, the utility values of the variables and transition between states. RESULTS No differences in restenosis rates between the two stents, although there were differences in the time of restenosis. The incremental cost effectiveness ratio (ICER) no discount rate was CH

Revisión˚˚ Sistemática˚˚ sobre˚˚ los˚˚ Efectos Adversos˚˚ de˚˚ la˚˚ Fluoración˚˚ del˚˚ Agua Systematic˚ ˚Review ˚˚of˚˚ the ˚˚Adverse˚ ˚Effects˚˚ of˚ ˚Water ˚˚Fluoridation

235.749 per QALY gained when using drug-eluting stent, the value below the equivalent of 1 Gross Domestic Product (PIB) per capita for 2011 in Chile. CONCLUSIONS The drug-eluting stent (SF) is cost effective compared to bare metal stent (SNF). The ICER is not affected by the sensitivity analysis (variability of cost, utility ranges used, probability of restenosis).