Tuesday, June 28, 2016

Check this out: Clopidogrel (Plavix) vs Ticagrelor (Brilinta) for ACS

Salam Ramadan al-Mubarak,

Superiority of ticagrelor, comparing with clopidogrel (PLATO Trial) - rate of death and overall major bleeding

"...patients who had an acute coronary syndrome with or without ST-segment elevation, treatment with ticagrelor, as compared with clopidogrel, significantly reduced the rate of death from vascular causes, myocardial infarction, or stroke, without an increase in the rate of overall major bleeding but with an increase in the rate of non–procedure-related bleeding..." (Wallentin et al., 2009)

Cost-effectiveness of ticagrelor, as single and combo (with ASA), comparing with clopidogrel

"...12 months of ACS treatment using ticagrelor/ASA instead of clopidogrel/ASA may offer a cost-effective therapeutic option, even when the generic price for clopidogrel is employed." (Theidel, Asseburg, Giannitsis & Katus, 2013)

"Ticagrelor is a clinically superior and cost-effective option for the prevention of thrombotic events among ACS patients in Canada." (Grima et al., 2014)

Pricing guide for ticagrelor and clopidogrel
Link: http://www.pharmacy.gov.my/v2/ms/apps/drug-price

Further discussion might be beneficial


Wallentin, L., Becker, R. C., Budaj, A., Cannon, C. P., Emanuelsson, H., Held, C., ... & Mahaffey, K. W. (2009). Ticagrelor versus clopidogrel in patients with acute coronary syndromes. New England Journal of Medicine361(11), 1045-1057.

Theidel, U., Asseburg, C., Giannitsis, E., & Katus, H. (2013). Cost-effectiveness of ticagrelor versus clopidogrel for the prevention of atherothrombotic events in adult patients with acute coronary syndrome in Germany. Clinical Research in Cardiology102(6), 447-458.
Grima, D. T., Brown, S. T., Kamboj, L., Bainey, K. R., Goeree, R., Oh, P., ... & Goodman, S. G. (2014). Cost-effectiveness of ticagrelor versus clopidogrel in patients with acute coronary syndromes in Canada. ClinicoEconomics and outcomes research: CEOR6, 49.

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