Cost-Effectiveness of Anticoagulation in Patients with Nonvalvular Atrial Fibrillation with Edoxaban Compared to Warfarin in Germany

Krejczy, Martin; Harenberg, Job; Wehling, Martin; Obermann, Konrad; Lip, Gregory Y.H.

doi:10.1155/2015/876923

Cited by 22 publications

(13 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients who might particularly benefit from NOACs include those who cannot take VKAs, have persistently poor TTR (e.g., < 65%) and those taking aspirin for stroke prevention for whom a NOAC may be an option ( Supporting local implementation of NICE guidance on use of the novel (non-Vitamin K antagonist) oral anticoagulants in non-valvular atrial fibrillation, 2015 ). A large reduction in medical cost was mainly driven by reductions in the risks of major bleedings with the NOACs ( Krejczy et al, 2015 ).…”

Section: Cost Effectiveness Of Noacsmentioning

confidence: 99%

Emerging Tools for Stroke Prevention in Atrial Fibrillation

2016

View full text Add to dashboard Cite

Ischaemic strokes resulting from atrial fibrillation (AF) constitute a devastating condition for patients and their carers with huge burden on health care systems. Prophylactic treatment against systemic embolization and ischaemic strokes is the cornerstone for the management of AF. Effective stroke prevention requires the use of the vitamin K antagonists or non-vitamin K oral anticoagulants (NOACs). This article summarises the latest developments in the field of stroke prevention in AF and aims to assist physicians with the choice of oral anticoagulant for patients with non-valvular AF with different risk factor profile.

show abstract

Section: Cost Effectiveness Of Noacsmentioning

confidence: 99%

Emerging Tools for Stroke Prevention in Atrial Fibrillation

2016

View full text Add to dashboard Cite

show abstract

“…There have been numerous published cost-effectiveness analyses comparing edoxaban and rivaroxaban with warfarin. 34 , 45 , 49 – 59 These studies have consistently showed that edoxaban and rivaroxaban are cost-effective relative to warfarin. However, few studies have set out to assess the particular value or cost-effectiveness of one NOAC versus another NOAC, and where such analyses have been conducted (albeit using an indirect comparison approach), there has been substantial inconsistency and contradiction between their findings.…”

Section: Discussionmentioning

confidence: 98%

Cost-effectiveness of edoxaban versus rivaroxaban for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF) in the US

Miller

Lenhart

et al. 2016

CEOR

View full text Add to dashboard Cite

BackgroundUnderstanding the value of new anticoagulation therapies compared with existing therapies is of paramount importance in today’s cost-conscious and efficiency-driven health care environment. Edoxaban and rivaroxaban for stroke prevention in nonvalvular atrial fibrillation (NVAF) patients with CHADS2 scores ≥2 have been evaluated in pivotal trials versus warfarin. The relative value of edoxaban versus rivaroxaban would be of interest to health care stakeholders and patients who prefer a once-daily treatment option for long-term stroke prevention in NVAF.ObjectiveTo evaluate the relative cost-effectiveness of two once-daily regimens of novel oral anticoagulation therapy – edoxaban (60 mg/30 mg dose-reduced) versus rivaroxaban (20 mg/15 mg dose-reduced) – for stroke prevention in NVAF patients from a US health-plan perspective.Materials and methodsA Markov model simulated lifetime risk and treatment of stroke, systemic embolism, major bleeding, clinically relevant nonmajor bleeding, myocardial infarction, and death in NVAF patients treated with edoxaban or rivaroxaban. Efficacy and safety data were derived from a network meta-analysis that utilized data from patients enrolled in ENGAGE AF-TIMI 48 and ROCKET-AF. Health care cost and utility data were obtained from published sources. Incremental cost-effectiveness ratios of $150,000 per quality-adjusted life year (QALY) gained were used as thresholds for “highly cost-effective”, “cost-effective”, and “not cost-effective” treatment options, respectively, as per American Heart Association/American College of Cardiology guidelines.ResultsEdoxaban was dominant relative to rivaroxaban, such that it was associated with lower total health care costs and better effectiveness in terms of QALYs in the base-case analysis. Results were supported by probabilistic sensitivity analyses that showed edoxaban as either dominant or a highly cost-effective alternative (incremental cost-effectiveness ratio <$50,000) to rivaroxaban in 88.4% of 10,000 simulations.ConclusionResults of this study showed that the once-daily edoxaban (60 mg/30 mg dose-reduced) regimen is a cost-saving or highly cost-effective treatment relative to rivaroxaban (20 mg/15 mg dose-reduced) for stroke prevention in NVAF patients with CHADS2 ≥2.

show abstract

“…In a study aimed to determine the cost-effectiveness of edoxaban versus warfarin in NVAF patients from the perspective of the Italian healthcare system, edoxaban was costeffective versus warfarin in 92.3% of the simulations at a willingness-to-pay threshold of 25,000 euros per quality-adjusted life year [92]. A study performed in Germany showed that the willingness-to-pay threshold was lowest for 60-mg edoxaban compared with all direct oral anticoagulants and for 30-mg edoxaban compared with dabigatran and rivaroxaban [93]. However, it should be emphasized that the cost-effectiveness of direct oral anticoagulants for stroke prevention in patients with NVAF is highly sensitive to warfarin anticoagulation control (poorer control, more cost-effective) [94].…”

Section: Expert Commentary and Five-year Viewmentioning

confidence: 98%

Edoxaban in the prevention and treatment of thromboembolic complications from a clinical point of view

Barrios

Escobar

2015

Expert Review of Cardiovascular Therapy

View full text Add to dashboard Cite

Edoxaban is an oral once-daily factor Xa inhibitor with a predictable anticoagulant effect. After oral administration, edoxaban is rapidly absorbed from the gastrointestinal tract, reaching the peak plasma concentrations at 1-2 h. Oral bioavailability is 62% in healthy subjects and the terminal half-life is approximately 10-14 h. Edoxaban has been extensively studied in three clinical scenarios. In ENGAGE AF-TIMI 48, edoxaban was at least as effective as warfarin, but with a marked lesser risk of bleeding. In the Hokusai-VTE study, edoxaban was as effective as warfarin for the prevention of recurrent venous thromboembolism (VTE) in patients with deep venous thrombosis, pulmonary embolism, or both, but with a lesser risk of bleeding. In the STARS program, edoxaban was more effective for the prevention of VTE after knee or hip arthroplasty than low-dose enoxaparin, without an increased bleeding risk. In this review, the available clinical evidence about edoxaban is updated.

show abstract

Cost-Effectiveness of Anticoagulation in Patients with Nonvalvular Atrial Fibrillation with Edoxaban Compared to Warfarin in Germany

Cited by 22 publications

References 44 publications

Emerging Tools for Stroke Prevention in Atrial Fibrillation

Emerging Tools for Stroke Prevention in Atrial Fibrillation

Cost-effectiveness of edoxaban versus rivaroxaban for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF) in the US

Edoxaban in the prevention and treatment of thromboembolic complications from a clinical point of view

Contact Info

Product

Resources

About