One-Year Cost-Effectiveness of Cytochrome P450 2C19 Genotype-Guided Antiplatelet Therapy in Patients with Acute Coronary Syndromes

The purpose of this study was to estimate the cost-effectiveness of using CYP2C19 genotype guided therapy with either prasugrel or clopidogrel in conjunction with aspirin therapy versus using routine dual antiplatelet therapy without genotyping in acute coronary syndrome (ACS) patients.

Using a Markov model, groups were assigned either to a clopidogrel or a prasugrel regimen in addition to baseline aspirin therapy, and measured according to five different health states. Hospitalization costs and the cost of ongoing care were also captured.

The study found that clinical outcomes would be improved and, on average, costs would be reduced by $120 annually for patients who were genotyped with a slight improvement in quality adjusted life years (QALY: 0.045).

Presented May 21, 2010, at the Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke 2010 Scientific Sessions. More information about this study can be found in the attached clinical brief.