Open AccessCost-Effectiveness and cost–utility analysis of the use of clopidogrel and pantoprazole in comparison with clopidogrel and omeprazole for the secondary prevention of myocardial infarction in Iran
Author(s) -
Mohammadreza Amirsadri,
Valiollah Hajhashemi,
Amir Shahriar Asemi
Publication year - 2021
Publication title -
journal of research in pharmacy practice
Language(s) - English
Resource type - Journals
eISSN - 2319-9644
pISSN - 2279-042X
DOI - 10.4103/jrpp.jrpp_21_22
Subject(s) - clopidogrel , medicine , omeprazole , pantoprazole , cyp2c19 , concomitant , myocardial infarction , proton pump inhibitor , cytochrome p450 , metabolism
Gastrointestinal bleeding, a side effect of clopidogrel, is usually prevented by proton-pump inhibitors (PPIs). Due to omeprazole's inhibitory effects on the liver enzyme CYP2C19, its concomitant use with clopidogrel is argued to increase the risk of myocardial infarction (MI) recurrence, as CYP2C19 activates clopidogrel. Pantoprazole as an alternative PPI has shown no inhibitory effect on CYP2C19. This study investigates the cost-effectiveness of concomitant use of clopidogrel and pantoprazole in MI patients compared to the simultaneous use of clopidogrel and omeprazole.