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A523 nated: rivaroxaban and dabigatran 150mg. The efficiency frontier was constructed by connecting the remaining strategies: warfarin and apixaban. Apixaban resulted in an incremental additional cost of 2,870€ and an incremental QALY of 0.189, corresponding to an ICER of 15,157€ /QALY versus warfarin. The PSA indicated that the probabilities for apixaban being cost-effective versus warfarin were respectively 80% and 90% at the informal willing-to-pay thresholds of 30,000€ and 50,000€. Sensitivity analysis identified stroke risk with apixaban and intracranial hemorrhage risk with warfarin as the variables most influencing the results. ConClusions: Apixaban may be the most economically efficient alternative to warfarin in NVAF patients eligible for stroke prevention in France. All other strategies are dominated. However, uncertainty surrounding these results should be investigated through real life data.

A523nated: rivaroxaban and dabigatran 150mg. The efficiency frontier was constructed by connecting the remaining strategies: warfarin and apixaban. Apixaban resulted in an incremental additional cost of 2,870€ and an incremental QALY of 0.189, corresponding to an ICER of 15,157€ /QALY versus warfarin. The PSA indicated that the probabilities for apixaban being cost-effective versus warfarin were respectively 80% and 90% at the informal willing-to-pay thresholds of 30,000€ and 50,000€ . Sensitivity analysis identified stroke risk with apixaban and intracranial hemorrhage risk with warfarin as the variables most influencing the results. ConClusions: Apixaban may be the most economically efficient alternative to warfarin in NVAF patients eligible for stroke prevention in France. All other strategies are dominated. However, uncertainty surrounding these results should be investigated through real life data.

Background: Colloid fluids supplemented with adequate combinations of coagulation factor concentrates with the capability to restore coagulation could be a desirable future treatment component in massive transfusion.Methods: Starting from a coagulation factor and blood cell-free albumin solution we added Prothrombin Complex Concentrate, Fibrinogen Concentrate and Factor XIII in different combinations and concentrations to analyze their properties to restore thromboelastometry parameters without the use of plasma. Further analysis under the presence of platelets was performed for comparability to whole blood conditions.Results: Albumin solutions enriched with Fibrinogen Concentrate, Factor XIII and Prothrombin Complex Concentrate at optimized concentrations show restoring coagulation potential. Prothrombin Complex Concentrate showed sufficient thrombin formation for inducing fibrinogen polymerization. The combination of Prothrombin Complex Concentrate and Fibrinogen Concentrate led to the formation of a stable in vitro fibrin clot. Fibrinogen and Factor XIII showed excellent capacity to improve fibrin clot firmness expressed as Amplitude at 10 minutes and Maximal Clot Firmness. Fibrinogen alone, or in combination with Factor XIII, was able to restore normal Amplitude at 10 minutes and Maximal Clot Firmness values. In the presence of platelets, the thromboelastometry surrogate parameter for thrombin generation (Clotting Time) improves and normalizes when compared to whole blood.Conclusions: Combinations of coagulation factor concentrates suspended in albumin solutions can restore thromboelastometry parameters in the absence of plasma. This kind of artificial colloid fluids with coagulation-restoring characteristics might offer new treatment alternatives for massive transfusion.Trial registration: Study registered at the institutional ethic committee “Institut de Recerca, Hospital Santa Creu i Sant Pau, with protocol number IIBSP-CFC-2013-165.