Cost-effectiveness of clopidogrel in patients with acute coronary syndrome undergoing percutaneous coronary intervention: a systematic review protocol.

Objective: This systematic review will assess the cost-effectiveness of clopidogrel in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).

Introduction: Antiplatelet drugs, including clopidogrel, ticagrelor, prasugrel, and aspirin, are crucial in managing ACS, preventing ischemia, and ultimately, death in PCI patients. Clopidogrel is the main treatment for those who have undergone PCI, used either alone or with aspirin. The incidence of ACS is rising globally, and is a major cause of premature death for millions. ACS management involves continuous medical therapy and costly procedures such as PCI, significantly straining health care resources.

Inclusion criteria: Studies will be eligible for inclusion if they report on the cost-effectiveness of clopidogrel in patients with ACS compared with other antiplatelet drugs.

Methods: This systematic review will adhere to the JBI methodology guidelines for systematic reviews of economic evaluation evidence. A preliminary search was conducted of MEDLINE (PubMed) using MeSH terms. Two independent reviewers will screen records at the title/abstract level, followed by full-text screening. Two reviewers will then assess methodological quality and extract data as per JBI guidelines. The JBI Dominance Ranking Matrix for economic evaluations will be used to summarize and compare the included studies. The cost-effectiveness measures will be incremental cost, incremental cost per quality-adjusted life year gained, or incremental cost per disability-adjusted life year averted. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach will be used to appraise the certainty of economic evidence, such as using resources and expenditure, for incorporating the results into the decision-making process.

Systematic review registration: PROSPERO CRD42024504614.