Cardiovascular prophylaxis with aspirin: costs of supply and management of upper gastrointestinal and renal toxicity
Key result
Low-dose aspirin is linked to ~£50 higher annual NHS costs vs nonusers, driven by complications.
- n=189,684
Why the study?
The cost to the NHS of prescribed low-dose aspirin including supply and management of upper gastrointestinal and renal toxicity was not well defined.
Does prescribed low-dose aspirin increase healthcare costs compared to nonuse due to supply and management of toxicity?
Population
17,244 new users of dispensed aspirin each with 10 matched comparators from Tayside Scotland
Comparison
Prescribed low-dose aspirin users vs matched aspirin nonusers
Design
Population-based observational cohort study
Follow-up
2.53 years
Authors
Discussion
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Implication
May add hidden NHS costs from complications; leaves open net value of low-dose aspirin in primary prevention.
Study Design
Type
Cohort (n=189,684)
Structured PICO
Does prescribed low-dose aspirin increase healthcare costs compared to nonuse due to supply and management of toxicity?
P
Population
189,684 individuals from Tayside Scotland, comprising 17,244 new users of low-dose aspirin and 172,440 matched nonusers, followed for an average of 2.53 years.
E
Exposure
Prescribed low-dose aspirin
C
Comparator
Matched cohort of aspirin nonusers
O
Outcome
Cost to the NHS (including supply, dispensing, and management of upper gastrointestinal and renal toxicity)
The true cost of low-dose aspirin prophylaxis to the healthcare system is 6 to 25 times higher than the drug cost alone due to dispensing fees and the management of gastrointestinal and renal adverse effects.
Limitations
- Costs may be underestimates due to the low compliance observed (47%).
- low compliance observed (47%) which may lead to underestimated costs
Cite This Study
Morant et al. (2003) conducted a cohort in Cardiovascular prophylaxis (n=189,684). Low-dose aspirin vs. Aspirin nonusers was evaluated on Excess costs to the NHS per year. Low-dose aspirin use cost the NHS an additional 49.86 UK pounds per year compared to nonusers, primarily due to dispensing and complication management costs.