Abstract 17295: Health Economics in the PLATelet inhibition and Patient Outcomes (PLATO) Randomized Trial: Report on Within Trial Resource Use Patterns
Background: The PLATO trial randomized 18,624 acute coronary syndrome (ACS) patients in 43 countries to ticagrelor + aspirin versus clopidogrel + aspirin and observed a significantly reduced risk of myocardial infarction, stroke or death from vascular causes with ticagrelor (hazard ratio 0.84, 95% CI 0.77 to 0.92). A health economics substudy was prospectively included as part of the PLATO research program.
Methods: Major resource units of relevance were incorporated onto the main study case report form and were collected on all PLATO patients through the end of study follow-up. These include bed days, interventions, investigations and blood products.
Results: Of the key resource use variables (see Table) ticagrelor resulted in 1149 fewer bed days (per patient mean difference 0.18, 95% CI −0.20 to 0.56) of which 712 were categorized as intensive care days occurring after the index hospitalization (per patient mean difference 0.08, 95% 0.01 to 0.15), 95 fewer PCIs (per patient mean difference 0.01, 95% CI −0.01 to 0.03) and 41 fewer CABGs (per patient mean difference 0.01, 95% CI −0.00 to 0.01) compared to the clopidogrel treated patients. Table. Selected per patient resource use patterns observed in the PLATO study
Conclusions: In the PLATO trial, ticagrelor produced significant reduction in ICU days occurring after the index hospitalization, non-significant reduction in overall bed days and a non-significant reduction in revascularization procedures. The effect of these shifts on net medical costs out to 1 year will be reported from the perspective of several of the main participating PLATO countries.
- Acute coronary syndromes
- Health economics
- Myocardial infarction
- Myocardial infarction, NSTEMI
- Myocardial infarction, STEMI
- © 2010 by American Heart Association, Inc.