PPI Cotherapy Is Cost-Effective in Patients Taking Aspirin

Many patients taking low-dose aspirin for secondary prevention of cardiovascular events discontinue therapy because of dyspepsia or upper gastrointestinal bleeding (UGIB). Might cotherapy with a proton-pump inhibitor (PPI) mitigate these effects and thereby increase compliance with aspirin therapy and improve cardiovascular outcomes? And would it be cost-effective?

Employing a modified Markov model of aspirin and PPI use, investigators explored these questions from the perspective of a long-term payer. They determined probabilities and risks for gastrointestinal and cardiovascular events from the available literature and obtained costs from the 2007 Healthcare Cost and Utilization Project.

The base-case analysis suggested that PPI and aspirin…