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Cost-effectiveness ...
Cost-effectiveness of ticagrelor plus aspirin versus aspirin in acute ischaemic stroke or transient ischaemic attack : an economic evaluation of the THALES trial
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- Tank, Amarjeet (författare)
- AstraZeneca, BioPharmaceut Business Unit, Cambridge, England.
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- Johnston, S. Claiborne (författare)
- Harbor Hlth, Austin, TX USA.
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- Jain, Ritika (författare)
- Parexel Int, Bengaluru, India.
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- Amarenco, Pierre (författare)
- Paris Univ, Bichat Hosp, Dept Neurol, Paris, France.;Paris Univ, Bichat Hosp, Stroke Ctr, Paris, France.
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- Mellstrom, Carl (författare)
- AstraZeneca, BioPharmaceut Business Unit, Gothenburg, Sweden.
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- Rikner, Klas (författare)
- AstraZeneca Nordics, Södertälje, Sweden.
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- Denison, Hans (författare)
- AstraZeneca, BioPharmaceut Res & Dev, Gothenburg, Sweden.
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- Ladenvall, Per (författare)
- AstraZeneca, BioPharmaceut Res & Dev, Gothenburg, Sweden.
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- Knutsson, Mikael (författare)
- AstraZeneca, BioPharmaceut Res & Dev, Gothenburg, Sweden.
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- Himmelmann, Anders (författare)
- AstraZeneca, BioPharmaceut Res & Dev, Gothenburg, Sweden.
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- Evans, Scott R. (författare)
- George Washington Univ, Biostat Ctr, Washington, DC USA.
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- James, Stefan, 1964- (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper
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- Molina, Carlos A. (författare)
- Vall Hebron Hosp, Stroke Unit, Barcelona, Spain.
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- Wang, Yongjun (författare)
- Capital Med Univ, Beijing Tiantan Hosp, Tiantan Comprehens Stroke Ctr, Beijing, Peoples R China.
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- Ouwens, Mario (författare)
- AstraZeneca, BioPharmaceut Business Unit, Real World Data Sci & Digital, Gothenburg, Sweden.
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AstraZeneca, BioPharmaceut Business Unit, Cambridge, England Harbor Hlth, Austin, TX USA. (creator_code:org_t)
- BMJ, 2023
- 2023
- Engelska.
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Ingår i: BMJ NEUROLOGY OPEN. - : BMJ. - 2632-6140. ; 5:2
- Relaterad länk:
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https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Objective THALES demonstrated that ticagrelor plus aspirin reduced the risk of stroke or death but increased bleeding versus aspirin during the 30 days following a mild-to-moderate acute non-cardioembolic ischaemic stroke (AIS) or high-risk transient ischaemic attack (TIA). There are no cost-effectiveness analyses supporting this combination in Europe. To address this, a cost-effectiveness analysis was performed.Methods Cost-effectiveness was evaluated using a decision tree and Markov model with a short-term and long-term (30-year) horizon. Stroke, mortality, bleeding and EuroQol-5 Dimension (EQ-5D) data from THALES were used to estimate short-term outcomes. Model transitions were based on stroke severity (disabling stroke was defined as modified Rankin Scale >2). Healthcare resource utilisation and EQ-5D data beyond 30 days were based on SOCRATES, another trial in AIS/TIA that compared ticagrelor with aspirin. Long-term costs, survival and disutilities were based on published literature. Unit costs were derived from national databases and discounted at 3% annually from a Swedish healthcare perspective.Results One-month treatment with ticagrelor plus aspirin resulted in 12 fewer strokes, 4 additional major bleeds and cost savings of euro95 000 per 1000 patients versus aspirin from a Swedish healthcare perspective. This translated into increased quality-adjusted life-years (0.04) and reduced societal costs (-euro1358) per patient over a lifetime horizon. Key drivers of cost-effectiveness were number of patients experiencing subsequent disabling stroke and degree of disability. Findings were robust over a range of input assumptions.Conclusion One month of treatment with ticagrelor plus aspirin is likely to improve outcomes and reduce costs versus aspirin in mild-to-moderate AIS or high-risk TIA.Trial registration number NCT03354429.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- stroke
- health economics
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Tank, Amarjeet
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Johnston, S. Cla ...
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Jain, Ritika
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Amarenco, Pierre
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Mellstrom, Carl
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Rikner, Klas
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Denison, Hans
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Ladenvall, Per
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Knutsson, Mikael
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Himmelmann, Ande ...
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Evans, Scott R.
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James, Stefan, 1 ...
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Molina, Carlos A ...
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Wang, Yongjun
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Ouwens, Mario
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BMJ NEUROLOGY OP ...
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Uppsala universitet