Review of cost-effectiveness of antithrombotic alternatives in patients with atrial fibrillation

Abstract

Costs and cost analysis and their Descritores em Ciências da Saúde, with the Boolean operators AND and OR, in a paired manner by two different researchers. Titles were assessed, followed by abstracts and finally the full texts according to the exclusion and inclusion criteria established. 4. The presentation of the search and selection of data from the Preferred Reporting Items for Systematic Review and Meta-Analyses review protocol (Figure 1). 5. The evaluation and synthesis of studies: studies were evaluated according to the seven levels of evidence 10 . The data are presented in tables and narratives. RESULTSThis review included 18 articles (Table 1) [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] assessed according to authors, year of publication, study design, country of publication, therapeutic alternatives versus cost, and principal conclusions. In the cost analysis, the main currencies of circulation were the euro [11][12][13][19][20][21][22][23] and the dollar [14][15][16][17][18][20][21][22]24,25 .The best quality-adjusted life years (QALYs) were conferred by the following: dabigatran, apixaban, warfarin, rivaroxaban, and edoxaban. Apixaban effectively reduces the number of cardiovascular events in relation to the vitamin K analogs apixaban and warfarin. It may be the first-line treatment for stroke prevention in patients with AF 11 and is cost-effective 17 . Dabigatran was more cost-effective than rivaroxaban and warfarin for patients with AF, besides reducing the risk of stroke, pulmonary embolism, and intracranial hemorrhage with low bleeding 12,14-20 .