Why the study?
Is cilostazol 200 mg/day cost-effective compared to aspirin 81 mg/day for the secondary prevention of cerebral infarction in 65-year-old patients?
Is cilostazol 200 mg/day cost-effective compared to aspirin 81 mg/day for the secondary prevention of cerebral infarction in 65-year-old patients?
Cilostazol appears to be a cost-effective alternative to aspirin for the secondary prevention of cerebral infarction, with an ICER of Yen 1.8 million per QALY.
May support cilostazol in cost-effectiveness models for secondary stroke prevention; leaves open need for randomized confirmation before practice change.
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.
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Inoue et al. (2006) studied this question.
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