We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editor's Correspondence |

Cost-effectiveness of Antiplatelet Therapies

Mark D. Schleinitz, MD
Arch Intern Med. 2001;161(9):1236. doi:.
Text Size: A A A
Published online


I read with great interest the article by Sarasin et al1 in the October 9, 2000, issue of the ARCHIVES. The authors have performed a thorough analysis of the cost-effectiveness of emerging antiplatelet therapies. A review of their data, however, reveals a point that will be particularly important for North American physicians. The authors cite "current market prices" (which I assume represent prices in Switzerland and Germany) as their source for the daily costs of aspirin with or without dipyridamole, resulting in a daily cost of the aspirin/dipyridamole combination of $0.60. The average US wholesale price for this medication, however, is $1.47 for the 25 mg/200 mg formulation, or roughly $2.95 for the dosage analyzed in the study.2 This is far outside the values used in their sensitivity analysis. The authors note that at a daily cost of $1.20 this regimen goes from a cost savings to a cost-effectiveness ratio of $3630 per quality-adjusted life-year. I calculate that this $0.60 increase from the base case cost adds an additional $4060 to the total cost of the aspirin/dipyridamole arm of their analysis. If one assumes a daily cost of $2.40, this would raise the total cost for this strategy by a total of $12 180, to $53 605. Thus, at a price approaching the average US wholesale price for aspirin/dipyridamole, its cost-effectiveness ratio is $30 697. This points out the importance of adjusting data used in cost-effectiveness analyses to reflect local prices because a therapy that is cost savings using what I presume to be Swiss prices has a significant cost increase when using the average US wholesale price.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles

Users' Guides to the Medical Literature
Matching Content and Context: Evidence-Based Teaching Scripts

Users' Guides to the Medical Literature
Verbal Synopses