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Aspirin-clopidogrel combination therapy for ischemic stroke patients: Clinical efficacy and cost-effectiveness analyses in low-resource setting Fitria, Najmiatul; Febiana, Dian; Akram, Muhammad; Yosmar, Rahmi
Narra J Vol. 4 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i2.758

Abstract

Understanding the cost-effectiveness of aspirin-clopidogrel combination therapy is crucial in determining its influence on coagulation parameters, specifically prothrombin time (PT) and activated partial thromboplastin time (APTT). The aim of this study was to assess the cost-effectiveness and clinical impact of using the aspirin-clopidogrel combination compared to aspirin alone in managing ischemic stroke. Employing an observational research design, inpatient ischemic stroke cases receiving the aspirin-clopidogrel combination were compared to those treated with aspirin alone. Focusing on the hospital's perspective on costs, the research specifically analyzed medical expenses without discounting costs or effects. The analysis involved comparing the direct medical costs and coagulation parameters between the two treatment groups. Our data revealed that the aspirin-clopidogrel combination demonstrated superior cost-effectiveness over aspirin alone, indicated by the incremental cost-effectiveness ratio (ICER) values for PT (IDR -246,930/second) and APTT (IDR -119,270/second). This indicated that the combination therapy was associated with lower costs while yielding better clinical parameter values. The ICER analysis placed the aspirin-clopidogrel combination in the southeast quadrant, marking its dominance over aspirin monotherapy by demonstrating higher effectiveness at lower costs. These results suggest that combination therapy might be a favorable alternative for managing ischemic stroke, presenting a viable option for consideration in clinical practice. The findings underscore the potential economic and clinical advantages of employing the aspirin-clopidogrel combination in routine stroke management protocols.
Evaluating Economic Outcomes: Single-Use Aspirin vs. Aspirin-Clopidogrel in Ischemic Stroke Patients Based on Barthel Index Scores Yosmar, Rahmi; Febiana, Dian; Fitria, Najmiatul
JSFK (Jurnal Sains Farmasi & Klinis) Vol 10 No 3 (2023): J Sains Farm Klin 10(3), Desember 2023
Publisher : Fakultas Farmasi Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jsfk.10.3.293-299.2023

Abstract

Ischemic stroke is a catastrophic disease that causes large costs in Indonesia. The high prevalence of stroke results in  increased morbidity and mortality rates, which will impact the socioeconomic status of stroke patients. Cost Effectiveness Analysis  (CEA) is a method in pharmaco-economics that aims to make decisions regarding the rational choice of therapy and evaluate  the economic impact on ischemic stroke patients. This study aims to determine the Incremental Cost Effectiveness Ratio (ICER)  value of antiplatelet therapy in the aspirin-clopidogrel combination group and the single aspirin group in ischemic stroke patients  treated at the Regional General Hospital. Dr. M. Djamil Padang. The clinical parameter observed was the Barthel Index (BI) value.  This research is a descriptive study with retrospective data collection using medical record data and the Hospital Management  Information System (SIMRS) at RSUD Dr. M.Djamil Padang. The cost data shows the total direct medical costs incurred in treating  ischemic stroke. Based on the results obtained, the Incremental Cost Effectiveness Ratio (ICER) value is IDR (-) 401,302. 71 per  1% increase. In this study it can be concluded that the aspirin-clopidogrel combination has better cost effectiveness than aspirin  alone.