One in five heart attack deaths could be prevented if patients were given AstraZeneca's Brilique instead of the current standard clopidogrel, research presented at the British Cardiovascular Society annual scientific conference in Manchester this week has confirmed.

In 2009, the international 18,000-patient PLATO study concluded that Brilique (ticagrelor) was actually more effective for heart attack patients than clopidogrel in reducing death and recurrent heart attack, but despite this, the medicine has not been as popular with doctors in the UK as hoped.

And now, a new analysis of the study has shown that Brilique is just as effective at reducing deaths in patients over the age of 75 as in younger patients, highlighting the "universal applicability of the treatment," said Robert Storey, Professor of Cardiology at the University of Sheffield's Department of Cardiovascular Science.

Brilique has been available in the UK since December last year, but its uptake has been disappointing, largely because of concerns over its seemingly high cost compared with the much cheaper generic clopidogrel, but the extra expense of AstraZeneca's drug would be offset by its greater efficacy and subsequent reduction in the need for expensive operations, the researchers note.

Indeed, according to an earlier analysis of PLATO, AZ's drug provides a cost-effective gain in quality-adjusted life year (QALY) - a crucial measure of cost-effectiveness - compared to generic clopidogrel (when used as per its European license), despite the fact that generic clopidogrel costs just 0.17 euros per day while Brilique's price tag ranges from 2.25 euros to 3.50 euros per day. 

"Many people are dying avoidably in the year after having a heart attack due to delays introducing this new treatment," stressed Prof Storey, and noted that the new findings "provide yet further evidence in support of making the drug available to patients in the UK".

Cost decisions

Last month the Scottish Medicine Consortium endorsed the use Brilique on NHS Scotland in patients with acute coronary syndromes, concluding that the drug is a cost-effective use of resources, while the National Institute for Health and Clinical Excellence is currently evaluating its use in England and Wales, with final guidance expected sometime in October. 

The long-term efficacy of Brilique is also currently being assessed in the PEGASUS study, which has recently kicked off in the UK and other countries, enrolling patients who have competed a year's course of treatment with the drug.