Pharmacoeconomic analysis of cilostazol for the secondary prevention of cerebral infarction.

BACKGROUND The antiplatelet agent, cilostazol, is known to reduce the risk of subsequent cerebral infarction. However, the cost effectiveness of such treatment in comparison to aspirin has not been studied. METHODS AND RESULTS A Markov model was developed to calculate the health outcomes and associated costs for 65-year-old patients with cerebral infarction who were treated with 200 mg/day cilostazol or 81 mg/day aspirin. Cilostazol was more effective, but also more expensive than aspirin. Cilostazol would extend quality-adjusted life years (QALY) by 0.64, while increasing life-time costs by approximately Yen 1.1 million. The incremental cost-effectiveness ratio of cilostazol in comparison with aspirin was estimated to be Yen 1.8 million per QALY. CONCLUSIONS The use of cilostazol to prevent recurrence of cerebral infarction appears to be cost effective.

[1]  Y. Matsuzawa,et al.  Large-scale cohort study on the relationship between serum lipid concentrations and risk of cerebrovascular disease under low-dose simvastatin in Japanese patients with hypercholesterolemia: sub-analysis of the Japan Lipid Intervention Trial (J-LIT). , 2005, Circulation journal : official journal of the Japanese Circulation Society.

[2]  J. Sasaki,et al.  Relation of serum total cholesterol and other factors to risk of cerebral infarction in Japanese men with hypercholesterolemia. , 2004, Circulation journal : official journal of the Japanese Circulation Society.

[3]  K. Ozasa,et al.  Relationship between abdominal visceral fat and lacunar infarcts in Japanese men. , 2004, Circulation journal : official journal of the Japanese Circulation Society.

[4]  K. Oka,et al.  Improvement in physiological outcomes and health-related quality of life following cardiac rehabilitation in patients with acute myocardial infarction. , 2004, Circulation journal : official journal of the Japanese Circulation Society.

[5]  Karen M Kuntz,et al.  Cost effectiveness of aspirin, clopidogrel, or both for secondary prevention of coronary heart disease. , 2002, The New England journal of medicine.

[6]  A. Connor,et al.  The way I see it: House officers need formal career development , 2002 .

[7]  A. Mattioli,et al.  Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients , 2002, BMJ : British Medical Journal.

[8]  Catherine Sudlow,et al.  Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients , 2002, BMJ : British Medical Journal.

[9]  J Raftery,et al.  NICE: faster access to modern treatments? Analysis of guidance on health technologies , 2001, BMJ : British Medical Journal.

[10]  J. Gaspoz,et al.  Cost-effectiveness of new antiplatelet regimens used as secondary prevention of stroke or transient ischemic attack. , 2000, Archives of internal medicine.

[11]  A. Terashi,et al.  Cilostazol stroke prevention study: A placebo-controlled double-blind trial for secondary prevention of cerebral infarction. , 2000, Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association.

[12]  S. Ebrahim.  Systematic review of cost-effectiveness research of stroke evaluation and treatment. , 1999, Stroke.

[13]  J R Beck,et al.  Markov Models in Medical Decision Making , 1993, Medical decision making : an international journal of the Society for Medical Decision Making.

[14]  S. Sonoda,et al.  Functional Evaluation after Stroke Using the FIM (Functional Independence Measure) , 1992 .

[15]  岩下 美喜雄.  Relation of serum total cholesterol and other factors to risk of cerebral infarction in Japanese men with hypercholesterolemia : the Kyushu lipid intervention study , 2007 .

[16]  T. Inomata,et al.  Cost-effectiveness analysis of carvedilol for the treatment of chronic heart failure in Japan. , 2004, Circulation journal : official journal of the Japanese Circulation Society.

[17]  Ebrahim,et al.  Systematic review of cost-effectiveness research of stroke evaluation and treatment , 1999, Stroke.