Heart attack prevention takes a step forward

Media release Medicines

Treatment for the heart condition acute coronary syndrome (ACS) gets a boost from 1 July with funding for the new generation blood thinning drug ticagrelor (Brilinta).

Heart disease continues to be one of New Zealand’s leading causes of death, with higher rates among men than women and amongst Māori and Pacific men in particular.

Anti-platelet therapy thins the blood to help prevent future heart attacks. Ticagrelor is a new type of anti-platelet agent, and is expected to be used alongside or instead of current treatments such as low-dose aspirin, clopidogrel and prasugrel.

PHARMAC medical director Dr Peter Moodie says ticagrelor funding will be for patients who have had particular types of heart attack, known as ST-elevation myocardial infarctions (STEMI), and non ST-elevation myocardial infarctions (NSTEMI).

“Standard treatment at present for most of these patients is clopidogrel, usually in combination with low-dose aspirin,” says Dr Moodie. “This is already effective at preventing future heart attacks, however the evidence shows that ticagrelor is a step forward compared to clopidogrel.”

Dr Moodie says PHARMAC’s analysis is based on the PLATO study, an 18,000 patient international trial that compared ticagrelor treatment with clopidogrel. The trial showed a statistically significant reduction in the rates of heart attack, both survived and fatal, in the patients using ticagrelor.

Dr Moodie says PHARMAC has been able to provide wider access to ticagrelor than previously proposed, thanks to an agreement with ticagrelor’s supplier AstraZeneca.

“This has allowed us to provide funding for 12 months treatment for each patient rather than six, while still maintaining affordability and cost-effectiveness,” says Dr Moodie.

“This means that about 3300 people in the first year of listing, and up to 12,200 by the fifth year, will benefit from ticagrelor treatment.”

Dr Moodie says PHARMAC expects funding of ticagrelor to total up to $14.3 million per year, although part of this will be rebated back to PHARMAC through a confidential agreement with the supplier.

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