{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T19:33:53Z","timestamp":1779305633395,"version":"3.51.4"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2022,4,30]],"date-time":"2022-04-30T00:00:00Z","timestamp":1651276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>To conduct a health economic evaluation of ticagrelor in patients with type 2 diabetes and coronary artery disease (CAD) from a multinational payer perspective. Cost\u2013effectiveness and cost\u2013utility of ticagrelor were evaluated in the overall effect of Ticagrelor on Health Outcomes in Diabetes Mellitus Patients Intervention Study (THEMIS) trial population and in the predefined patient group with prior percutaneous coronary intervention.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>A Markov model was developed to extrapolate patient outcomes over a lifetime horizon. The primary outcome was incremental cost\u2013effectiveness ratios (ICERs), which were compared with conventional willingness-to-pay thresholds [\u20ac47 000\/quality-adjusted life-year (QALY) in Sweden and \u20ac30 000\/QALY in other countries].<\/jats:p>\n                  <jats:p>Treatment with ticagrelor resulted in QALY gains of up to 0.045 in the overall population and 0.099 in patients with percutaneous coronary intervention (PCI). Increased costs and benefits translated to ICERs ranged between \u20ac27 894 and \u20ac42 252\/QALY across Sweden, Germany, Italy, and Spain in the overall population. In patients with prior PCI, estimated ICERs improved to \u20ac18 449, \u20ac20 632, \u20ac20 233, and \u20ac13 228\/QALY in Sweden, Germany, Italy, and Spain, respectively, driven by higher event rates and treatment benefit.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Based on THEMIS results, ticagrelor plus aspirin compared with aspirin alone may be cost\u2013effective in some European countries in patients with T2DM and CAD and no prior myocardial infarction (MI) or stroke. Additionally, ticagrelor is likely to be cost\u2013effective across European countries in patients with a history of PCI.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcvp\/pvac032","type":"journal-article","created":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T19:33:19Z","timestamp":1651087999000},"page":"777-785","source":"Crossref","is-referenced-by-count":6,"title":["Cost\u2013effectiveness of ticagrelor in patients with type 2 diabetes and coronary artery disease: a European economic evaluation of the THEMIS trial"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6896-2941","authenticated-orcid":false,"given":"Philippe Gabriel","family":"Steg","sequence":"first","affiliation":[{"name":"Universit\u00e9 de Paris, AP-HP, H\u00f4pital Bichat, FACT (French Alliance for Cardiovascular trials) and INSERM-U1148 , Paris , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepak L","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Department of Medicine, Brigham and Women's Hospital Heart and Vascular Center and Harvard Medical School , Boston, MA 02115 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4413-9736","authenticated-orcid":false,"given":"Stefan K","family":"James","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University Hospital, 752 37 Uppsala , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver","family":"Darlington","sequence":"additional","affiliation":[{"name":"Health Economics and Outcomes Research Ltd , Unit A Copse Walk, Cardiff Gate Business Park, Cardiff CF23 8RB, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise","family":"Hoskin","sequence":"additional","affiliation":[{"name":"Health Economics and Outcomes Research Ltd , Unit A Copse Walk, Cardiff Gate Business Park, Cardiff CF23 8RB, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tabassome","family":"Simon","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology , H\u00f4pital Saint Antoine, Unit\u00e9 de Recherche Clinique, 75012 Paris , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim M","family":"Fox","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College and Royal Brompton Hospital , London SW3 6NP, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence A","family":"Leiter","sequence":"additional","affiliation":[{"name":"Li Ka Shing Knowledge Institute of St. Michael's Hospital, University of Toronto , Toronto, ON M5B 1T8, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shamir R","family":"Mehta","sequence":"additional","affiliation":[{"name":"Hamilton Health Sciences, Population Health Research Institute, McMaster University , Hamilton, ON L8S 4L8, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert A","family":"Harrington","sequence":"additional","affiliation":[{"name":"Department of Medicine, Stanford University , Stanford, CA 94305 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anders","family":"Himmelmann","sequence":"additional","affiliation":[{"name":"BioPharmaceuticals R&D, Cardiovascular, Renal and Metabolic, AstraZeneca , 431 50 Gothenburg , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilhelm","family":"Ridderstr\u00e5le","sequence":"additional","affiliation":[{"name":"BioPharmaceuticals R&D, Cardiovascular, Renal and Metabolic, AstraZeneca , 431 50 Gothenburg , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marielle","family":"Andersson","sequence":"additional","affiliation":[{"name":"BioPharmaceuticals R&D, Cardiovascular, Renal and Metabolic, AstraZeneca , 431 50 Gothenburg , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00e9ctor","family":"Bueno","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Doce de Octubre, 28007 Madrid , Spain"},{"name":"MTCR Group, Centro Nacional de Investigaciones Cardiovasculares , 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonardo","family":"De Luca","sequence":"additional","affiliation":[{"name":"Department of Cardiosciences, A.O. 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