Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

<jats:sec><jats:title>Background</jats:title><jats:p> Long-term antiplatelet treatment is associated with major bleeding. </jats:p></jats:sec><jats:sec><jats:title>Aims</jats:title><jats:p> To determine the costs associated with major bleeding in patients treated with aspirin-based antiplatelet treatment for secondary prevention of vascular events without routine prescription of proton-pump inhibitors and to estimate the likely long-term savings from routine co-prescription. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> In a prospective population-based cohort study of TIA, ischemic stroke, and MI treated with antiplatelet drugs, we evaluated hospital care costs associated with bleed management during 10-year follow-up. Bleeding-associated costs were averaged across all patients. For upper GI-bleeds, mean costs were compared with the cost of routine co-prescription of proton-pump inhibitor. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> Among 3166 patients on antiplatelet therapy with 405 first bleeding events, the average cost of major bleeding was $13,093 (S.D. 20,501), with similar costs for upper GI bleeds and intracranial bleeds ( p = 0.235). However, total costs among the 3166 patients were higher for upper GI bleeds ($1,158,385 vs. $740,123). Averaged across all patients, the 10-year cost of major bleeding was $838 (95%CI: 680–1007), $411 due to upper GI bleeding, the cost of which increased from $175 in those aged &lt;75 years to $644 at age ≥75 years ( p &lt; 0.0001). The corresponding costs of routine life-long co-prescription of proton-pump inhibitor to those patients not on prior treatment were $85 (84–88) and $39 (38–42). </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> In secondary prevention with aspirin-based antiplatelet treatment without routine proton-pump inhibitor use, the long-term costs of upper-GI bleeding at age ≥75 years are much higher than at younger age groups, and are at least 10-fold greater than the drug cost of routine co-prescription of proton-pump inhibitor. </jats:p></jats:sec>

Original publication

DOI

10.1177/1747493019879658

Type

Journal

International Journal of Stroke

Publisher

SAGE Publications

Publication Date

30/09/2019

Pages

174749301987965 - 174749301987965