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Dual Antiplatelet Therapy Following Percutaneous Coronary Intervention: Clinical and Economic Impact of Standard Versus Extended Duration

Last updated: April 4, 2019
Project Number: OP0533-000
Product Line: Optimal Use
Result type: Report

This project evaluated the clinical and economic effectiveness of extending dual antiplatelet therapy, or DAPT (i.e., a combination of ASA and a P2Y12 inhibitor), following percutaneous coronary intervention (PCI). This project aimed to answer the following policy questions:

Policy Question 1: Should P2Y12 inhibitors (i.e., clopidogrel, prasugrel, or ticagrelor) be reimbursed for use beyond 12 months in combination with ASA for patients who recently underwent PCI with bare-metal stent (BMS) or drug-eluting stent (DES) insertion?

Policy Question 2: Which of the P2Y12 inhibitors (clopidogrel, prasugrel, or ticagrelor) should be reimbursed for use beyond 12 months in combination with ASA for patients who underwent PCI with BMS or DES insertion?

A recommendations report was also produced. This report includes recommendations for the optimal use of DAPT in terms of duration of clinical utilization and reimbursement. Recommendations were based on findings from the science report, as well as stakeholder feedback.