Budget Impact Analysis Of Apixaban Versus Other Noacs For The Prevention Of Stroke In Italian Non-Valvular Atrial Fibrillation Patients

Abstract

A479ates the financial impact of apixaban introduction by comparing expected 1,2, and 3 years costs in hypothetical scenarios: with and without apixaban. Italian NVAF patient population estimation is based on official apixaban reimbursement criteria, applying the characteristics of the trial population to national epidemiologic data. Sensitivity analysis is performed on an alternative non-experimental population of NVAF patients. Results: Among available NOACs, apixaban is expected to be the least expensive at 1,2, and 3 years in an estimated patient population of 364,000 Italian patients, allowing for savings of over 5 million € by the third year. Results of the simulation run on an alternative non-experimental population of NVAF patients yields comparable estimates. Exclusive use of apixaban for three years in the identified population would allow for savings of € 8,832,500, € 14,446,551 and € 27,282,998 when compared with dabigatran (110 mg), dabigatran (150 mg) and rivaroxaban, respectively. ConClusions: The different safety and effectiveness profiles of the available NOACs emerging from the adjusted indirect comparison indicate that the introduction of apixaban could improve health care expenditure control while maintaining or increasing therapeutic appropriateness in the Italian NVAF population.