Analisi di costo efficacia dei nuovi anticoagulanti orali nella prevenzione dell’ictus in pazienti con fibrillazione atriale non valvolare in Italia

Ravasio, Roberto; Pedone, Maria Paola; Ratti, Marco

doi:10.1007/s40276-014-0022-x

Cited by 4 publications

(2 citation statements)

References 30 publications

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“…These events were subsequently quantified using the costs reported in a recent Italian analysis, which assessed the cost-effectiveness of the non-vitamin k oral anticoagulants in the prevention therapy in NVAF patients [16]. An average cost of € 14,500 for the intracranial hemorrhage event (this amount takes into account the management of a moderate stroke -Barthel Index ≤ 14 and ≥ 10 -and a possible disability) and € 6,940.80 for the major extracranial bleeding event were considered.…”

Section: Number and Cost Of The Eventsmentioning

confidence: 99%

Budget impact analysis of dabigatran compared with rivaroxaban in the prevention of the thromboembolic risk in patients with non-valvular atrial fibrillation

Celeste

Marco

Fresco

et al. 2017

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BACKGROUND: Dabigatran 150 mg BID (D150) and rivaroxaban 20 mg (R20) are indicated for the prevention of thromboembolic events in patients with Non-Valvular Atrial Fibrillation (NVAF). Outcomes from observational study demonstrated that D150 and R20 reduced the rate of thromboembolic events. OBJECTIVE: This analysis estimated the budget impact of the use of D150 and R20 for the treatment of NAFV patients in Italy. METHODS: A budget-impact model (BIM) was developed to estimate the direct costs up to 12 months from an Italian NHS perspective. The resource utilization (drugs and intracranial hemorrhage or major extracranial bleeding event) was derived from an observational study. Only direct medical costs were considered. Ex-factory prices and National Tariffs were considered to estimate the costs of drugs and medical resource used, respectively. The BIM showed the difference of expenditure and clinical events (intracranial hemorrhage or major extracranial bleeding) generated by the base case calculated for current prescription volumes (D150 30%, R20 100%), and for different prescription volume scenarios (D150 at 70% and 100%). Key variables were tested in the sensitivity analysis. RESULTS: D150 was associated with a medical cost offset driven by fewer intracranial hemorrhage and major extracranial bleeding event, these offset the incremental drug cost and results in an annual saving per patient treated (D150: € 1,052.78; R20: € 1,161.23). The present scenario determines an annual cost of € 262,543,583. The impact of total annual costs for the Italian NHS would be lower if D150 prescription volumes would be higher. The total cost is predicted to decrease by 3.8% if the D150 prescription increase to 70% and it is predicted to decrease by 6.7% if the D150 prescription increase to 100%. CONCLUSION: The use of D150, as an alternative to R20 to prevent events in patients with NVAF, could represent a costsaving option for the Italian NHS.

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Section: Number and Cost Of The Eventsmentioning

confidence: 99%

Budget impact analysis of dabigatran compared with rivaroxaban in the prevention of the thromboembolic risk in patients with non-valvular atrial fibrillation

Celeste

Marco

Fresco

et al. 2017

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“…Purtroppo, almeno fino a ora, tali provvedimenti non hanno ottenuto i risultati attesi, presentando ancora un rapporto rischio/beneficio sfavorevole. Queste considerazioni portano a ritenere che, nonostante la spesa per l'acquisto degli AVK sia irrisoria, la quota di budget sanitario pubblico impiegata risulti rilevante (2,53% vs 2% riportato dalla letteratura) (36). Pertanto, è auspicabile un miglioramento tecnico nella gestione degli AVK o l'impiego di una nuova classe di farmaci, quali i NAO, dotati di un profilo di sicurezza maggiore.…”

Section: Conclusioniunclassified

Thromboprophylaxis in Patients with Atrial Fibrillation: A Real Practice Analysis

Deambrosis

Bettiol

Bolcato

et al. 2016

Global & Regional Health Technology Assessment

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2,5% (2-4). Nel nostro Paese recenti studi hanno evidenziato una prevalenza di circa l'1,85% (5, 6). Gli uomini presentano una prevalenza superiore al sesso femminile. L'incidenza è aumentata del 13% negli ultimi 20 anni e, negli individui di 40 anni di età, il rischio di presentare FA nel resto della vita è di circa il 25% (5, 6). La presenza di FA aumenta il rischio tromboembolico (1) con conseguente incremento dell'incidenza di: ictus (fino a 5 volte), mortalità (~2 volte) e scompenso cardiaco (2). Inoltre, l'ictus derivante dalla presenza di FA risulta essere con maggiore frequenza ricorrente, disabilitante e fatale (7-10). Tutto ciò comporta un elevato tasso di ospedalizzazione e un notevole incremento degli oneri sociali (3). In questi pazienti è indispensabile, prima di intraprendere un trattamento farmacologico, valutare il rischio di ciascun

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Economic evaluation of stroke treatment in Italy: systematic literature review

Belfiore

2018

International Journal of Healthcare Management

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Analisi di costo efficacia dei nuovi anticoagulanti orali nella prevenzione dell’ictus in pazienti con fibrillazione atriale non valvolare in Italia

Cited by 4 publications

References 30 publications

Budget impact analysis of dabigatran compared with rivaroxaban in the prevention of the thromboembolic risk in patients with non-valvular atrial fibrillation

Budget impact analysis of dabigatran compared with rivaroxaban in the prevention of the thromboembolic risk in patients with non-valvular atrial fibrillation

Thromboprophylaxis in Patients with Atrial Fibrillation: A Real Practice Analysis

Economic evaluation of stroke treatment in Italy: systematic literature review

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