Clinical and economic consequences in patients initiating therapy with clopidogrel brand-name vs. generic: A real-life retrospective study
Por:
Sicras-Mainar A, Escobar-Cervantes C, Micó-Pérez RM and Llisterri-Caro JL
Publicada:
1 ene 2020
Ahead of Print:
22 jul 2019
Resumen:
Objective: To evaluate the adherence to treatment, resource use, and costs in subjects initiating treatment with brand-name versus generic clopidogrel for acute coronary syndrome (ACS) and peripheral arterial disease (PAD).
Patients and methods: Observational, retrospective study based on the medical records of patients aged >= 18 years who initiated treatment with clopidogrel (brand-name vs. generic) between 4 April 2015 and 31 March 2017. Four study groups were compared, and the follow-up was one year. The main measurements were: comorbidity, treatment adherence, medication possession ratio (MPR), resource use, and costs. The results were analysed using multivariate analysis. The level of statistical significance was P < .05.
Results: Four groups were compared: a) ACS: brand-name clopidogrel (N = 1,067) vs. generic (N = 3,504), and b) PAD: brand-name clopidogrel (N = 425) vs. generic (N = 994). In the ACS comparison (mean age: 69.7 years, 61.4% male), adherence (65.3% vs. 61.0%, P < .001), adjusted hazard ratio 0.85 and MPR (89.8% vs. 86.7%, P = .045) were more superior with brand-name clopidogrel than with the generic and with a lower mean cost per unit ((sic) 2,890 vs. (sic) 3,865, P = .001). In the PAD comparison, similar results were observed: persistence (64.7% vs. 58.9%, P = .039); adjusted hazard-ratio 0.86 and MPR (88.6% vs. 81.7%; P = .013) were more superior with brand-name clopidogrel than for the generic, with a lower mean cost per unit ((sic) 2,880 vs. (sic) 3,532, P = .044).
Conclusions: There was better treatment adherence in patients initiating treatment with brand-name compared with generic clopidogrel for ACS and PAD, resulting in lower health costs for the Spanish National Health System. (C) 2019 Sociedad Espanola de Medicos de Atencion Primaria (SEMERGEN). Published by Elsevier Espana, S.L.U. All rights reserved.
Filiaciones:
Sicras-Mainar A:
Dirección Científica, HEOR, Real Life Data, Madrid, España
Escobar-Cervantes C:
Servicio de Cardiología, Hospital Universitario La Paz, Madrid, España
:
Consultorio Fontanars dels Alforins, EAP Ontinyent, Valencia, España
:
Fundación de Investigación SEMERGEN, Madrid, España
|