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Clopidogrel is more effective than aspirin in preventing recurrent vascular events, but concerns about its cost-effectiveness have limited its use. We evaluated the cost-effectiveness of clopidogrel and aspirin as secondary prevention in patients with a prior myocardial infarction, a prior stroke, or peripheral arterial disease. We constructed Markov models assuming a societal perspective, and based analyses on the lifetime treatment of a year-old patient facing event probabilities derived from the Clopidogrel versus Aspirin in Patients at Risk of Ischemic Events CAPRIE trial as the base case.
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At the June meeting, the PBAC recommended the listing of clopidogrel for the secondary prevention of ischaemic stroke, transient cerebral ischaemic events, myocardial infarction and unstable angina in patients with a history of cardiac ischaemic events or cerebrovascular ischaemic episodes while on therapy with low-dose aspirin. Listing was effective from 1 November Listing was effective from 1 February At the November meeting, the PBAC recommended the listing of a fixed dose combination product containing clopidogrel 75 mg with aspirin mg as an Authority Required Streamlined item on a cost-minimisation basis compared with clopidogrel alone.
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