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<p>The PLATO trial randomized more than 18,000 acute coronary syndrome (ACS) patients to dual anti-platelet therapy with aspirin plus either clopidogrel or the newer P2Y12 inhibitor ticagrelor. Compared with clopidogrel-treated patients, those on ticagrelor had lower rates of death and myocardial infarction at 1 year. Despite superior ischemic outcomes, both ticagrelor and the thienopyridine prasugrel have been relatively slow to be adopted in the United States. This is at least in part due to the cost differential, as the older clopidogrel is available as a generic, while the newer agents enjoy continued brand exclusivity. The National Average Drug Acquisition Cost data collected by CMS currently reports a 70-fold difference in price between clopidogrel and ticagrelor.</p>

Ticagrelor Cost Effective as Well as Efficacious, According to New Analysis