Comparison of hospital length of stay and hospitalization costs among patients with non-valvular atrial fibrillation treated with apixaban or warfarin: An early view

Abstract

Among NVAF patients, apixaban treatment was associated with significantly shorter hospital LOS and lower costs when compared to warfarin treatment.

Shortened hospital length of stay and lower costs associated with rivaroxaban in patients with pulmonary embolism managed as observation status

“…When Xie and colleagues used the Premier database to compare NVAF patients receiving apixaban (n=2886) to propensity score matched warfarin users (n=2886), apixaban was associated with a shorter hospital LOS (5.1 vs 5.7 days, P =.002) . Moreover, a 13% shorter LOS was observed with dabigatran vs propensity score matched warfarin users ( P <.001) in an analysis of 1938 NVAF hospitalisations using USA claims data . Taken together, these studies and our data suggest that reductions in LOS may be achieved with the use of a DOAC (vs warfarin) across two unique disease states.…”

“…In a claims database analysis of 13 894 NVAF patients hospitalised in the USA, an ~1 day shorter LOS was observed with rivaroxaban vs propensity score matched warfarin users ( P <.001). Similarly, shortened hospital LOS has been observed with other DOACs vs warfarin in NVAF patients . When Xie and colleagues used the Premier database to compare NVAF patients receiving apixaban (n=2886) to propensity score matched warfarin users (n=2886), apixaban was associated with a shorter hospital LOS (5.1 vs 5.7 days, P =.002) .…”

“…Direct oral anticoagulants (DOACs), such as rivaroxaban, eliminate the need for bridging therapy and laboratory monitoring, and may allow for shortened LOS and subsequent cost reductions. While randomised controlled trials and claims‐based analyses have shown DOACs can reduce LOS in venous thromboembolism (VTE) and non‐valvular atrial fibrillation (NVAF) patients, these reductions have yet to be demonstrated in observation stay managed PE patients treated in the real world. Our aim was to compare index hospital LOS, hospital treatment costs and risk of readmission related to treatment complication in PE patients managed through observation stays treated with either rivaroxaban or parenterally bridged warfarin.…”

Apixaban or Rivaroxaban Versus Warfarin for Treatment of Submassive Pulmonary Embolism After Catheter-Directed Thrombolysis

“…There have been several studies evaluating the impact of DOACs on hospital LOS and the subsequent cost savings incurred from prescribing these agents. 12 –27 Among those specifically looking at PE, the only DOAC that has been evaluated is rivaroxaban. In a post hoc analysis of the EINSTEIN-PE trial, rivaroxaban was associated with a 1.7-day mean reduction in hospital LOS versus LMWH/warfarin ( P = .0002).…”

Non-Vitamin K Antagonist Oral Anticoagulants: Redefining the Role of the Nurse to Improve Patient Care

“…The increasing uptake of non-VKA OACs in primary care is transforming the management of patients and the transition from hospital to home. Non-VKA OAC therapy was associated with a significantly shorter length of hospital stay compared with warfarin in patients hospitalized for non-valvular AF, DVT or PE [30]- [33], and does not required routine international normalized ratio (INR) testing. This has reshaped the role of nurses involved in anticoagulation therapy, and has provided the opportunity for a nurse-led approach with a greater focus on patient contact, education and the ongoing assessment of adherence and compliance.…”