Cost-effectiveness of new oral anticoagulants in the prevention of stroke in patients with atrial fibrillation

Kansal, Anuraag R.; Zheng, Ying; Pokora, Tiffany; Sorensen, Sonja

doi:10.1016/j.beha.2013.07.012

Cited by 29 publications

(17 citation statements)

References 38 publications

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“…Despite methodological differences, our findings are in line with those from previously published analyses, confirming the cost effectiveness of new oral anticoagulants in different settings [65]. In fact, in several studies, dabigatran etexilate was found to be cost effective among different countries and settings [61,[66][67][68][69].…”

Section: Discussionsupporting

confidence: 94%

Cost Effectiveness of Rivaroxaban for Stroke Prevention in German Patients with Atrial Fibrillation

et al. 2014

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Our results showed that the substantially higher medication costs of rivaroxaban were offset by mitigating the shortcomings of warfarin, most notably frequent dose regulation and bleeding risk. Future health economic studies on novel oral anticoagulants should evaluate the cost effectiveness for secondary stroke prevention and, as clinical data from direct head-to-head comparisons become available, new anticoagulation therapies should be compared against each other.

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Section: Discussionsupporting

confidence: 94%

Cost Effectiveness of Rivaroxaban for Stroke Prevention in German Patients with Atrial Fibrillation

et al. 2014

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“…Several studies have investigated the cost benefits of NOACs compared with warfarin using real‐world claims data or Markov models [ 26‐28 ] ; however, there are less data comparing costs between different NOACs. [ 29,30 ] Using the IMS Pharmetrics Plus database, Lin et al .…”

Section: Discussionmentioning

confidence: 99%

Comparison of healthcare costs among patients with non‐valvular atrial fibrillation treated with warfarin who switched to a novel oral anticoagulant

Franchino‐Elder

Gilligan

Song

et al. 2020

J Pharm Health Serv Res

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Objective To compare all‐cause healthcare costs among non‐valvular atrial fibrillation (NVAF) patients who switched from warfarin to novel oral anticoagulants (NOAC). Methods Adult NVAF patients who switched from warfarin to dabigatran, rivaroxaban or apixaban were identified in MarketScan claims databases between 10/01/2010 and 12/31/2015. Patients were continuously enrolled for 12 months before the first NOAC claim and followed for 12 months or until medication switch, discontinuation, inpatient death or 12/31/2016. Dabigatran patients were matched 1 : 1 separately to rivaroxaban and apixaban. All‐cause costs were reported as per‐patient‐per‐month (PPPM) in 2017 US dollars. Key findings A total of 8679 and 5761 dabigatran switchers were matched to rivaroxaban and apixaban switchers respectively (mean age 73–74 years; mean CCI 1.8–2.0). Compared with rivaroxaban, dabigatran switchers had significantly lower PPPM mean outpatient (OP) ($1265 versus $1587, P < 0.001), emergency department (ED, $67 versus $95, P < 0.001), OP office ($114 versus $119, P = 0.003), other OP services ($1085 versus $1373, P < 0.001) and OP pharmacy costs ($624 versus $660, P < 0.001). Compared with apixaban, dabigatran switchers had significantly lower mean PPPM ED ($67 versus $123, P < 0.001), OP office ($116 versus $121, P = 0.032), other OP services ($1062 versus $1434, P < 0.001), OP pharmacy ($633 versus $706, P < 0.001) and total healthcare costs ($3254 versus $3805, P = 0.016). Conclusions Outpatient costs were considerably lower among dabigatran switchers compared with rivaroxaban. Total and OP healthcare costs were significantly lower for patients switching from warfarin to dabigatran versus apixaban. Use of dabigatran following warfarin discontinuation may enable healthcare cost savings among NVAF patients, as compared with rivaroxaban or apixaban.

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“…In the United States, the threshold of $100 000 per quality adjusted life years has been favored as the additional cost that justifies the clinical benefit. 77 Across the multiple models used by investigators in the various countries, populations, and dosing regimens, the 150-mg twice-daily dose of dabigatran appears to be more cost-effective than VKA or aspirin. 77 Similar findings were reported with cost-effective analyses of rivaroxaban 78 and apixaban 79 based on the ROCKET-AF and ARISTOTLE trials, respectively.…”

Section: Costmentioning

confidence: 99%

Target-Specific Oral Anticoagulants: Practice Issues for the Clinician

Plitt

Giugliano

2014

Hospital Practice

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Venous thromboembolism and atrial fibrillation are among the most common cardiovascular disorders in the United States. For over 50 years, the standard of care has been anticoagulation with vitamin K antagonists. However, the numerous limitations of vitamin K antagonists led to the development of target-specific oral anticoagulants. Dabigatran, rivaroxaban, apixaban, and edoxaban have been shown to be as effective as warfarin in the treatment and prevention of venous thromboembolism and prevention of stroke in nonvalvular atrial fibrillation. This article compares the basic pharmacologic properties of these anticoagulants, reviews the data supporting their use, and discusses practical clinical issues including measurement of the anticoagulation effect, reversal strategies, and management of patients prior to surgery.

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Cost-effectiveness of new oral anticoagulants in the prevention of stroke in patients with atrial fibrillation

Cited by 29 publications

References 38 publications

Cost Effectiveness of Rivaroxaban for Stroke Prevention in German Patients with Atrial Fibrillation

Cost Effectiveness of Rivaroxaban for Stroke Prevention in German Patients with Atrial Fibrillation

Comparison of healthcare costs among patients with non‐valvular atrial fibrillation treated with warfarin who switched to a novel oral anticoagulant

Target-Specific Oral Anticoagulants: Practice Issues for the Clinician

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