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. 2017 Apr;12(2):144-153.
doi: 10.4103/1735-5362.202453.

Cost-effectiveness evaluation of aspirin in primary prevention of myocardial infarction amongst males with average cardiovascular risk in Iran

Mohammadreza Amirsadri  1 , Mohammad Javad Sedighi  1
Affiliations

Cost-effectiveness evaluation of aspirin in primary prevention of myocardial infarction amongst males with average cardiovascular risk in Iran

Mohammadreza Amirsadri et al. Res Pharm Sci. 2017 Apr.

Abstract

Aspirin is one of the certified medicines commonly used for the secondary prevention of myocardial infarction (MI). Aspirin side effects and gastrointestinal bleeding, in particular, have arisen debates on its use for the primary prevention of MI. The present research evaluates the cost-effectiveness of the use of aspirin in the primary prevention of MI among Iranian men with average cardiovascular disease (CVD) risk, using Markov modeling technique. The incremental cost-effectiveness ratios (ICERs) estimated to be 864 USA dollars (USD) per quality-adjusted life years (QALY) gained and 782 USD per life years gained (LYG) for each patient in the base-case scenario (public tariffs and no discounting). This research proves cost-effectiveness of the use of aspirin in the primary prevention of MI in targeted population, since the assessed ICERs are quite under the recommended threshold by WHO which is one gross domestic product (GDP) per capita ($5315.1 for Iran in 2015).

Keywords: Aspirin; Cardiovascular diseases; Cost-effectiveness; Markov chain; Primary prevention.

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Figures

Fig. 1
Fig. 1
The semi-Markov model. (GIB) gastrointestinal bleeding; (MI) myocardial infarction; other death, death because of causes except MI and GIB.
Fig. 2
Fig. 2
One-way sensitivity analysis of incremental cost/LYG (public tariffs). (LYG) life years gained.
Fig. 3
Fig. 3
One-way sensitivity analysis of incremental cost/QALY (public tariffs). (QALY) quality-adjusted-life-years.
Fig. 4
Fig. 4
Probabilistic sensitivity analyses scatter plot of incremental cost/LYG ratio (public tariffs). (LYG) life years gained.
Fig. 5
Fig. 5
Probabilistic sensitivity analyses scatter plot of Incremental cost/QALY ratio (public tariffs). (QALY) quality-adjusted life years.
Fig. 6
Fig. 6
Cost-effectiveness acceptability curve plot of aspirin therapy versus no medication.
See this image and copyright information in PMC

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