PCV28 2-Year Incidence of Stroke and Hemorrhages Hospitalizations and Costs Within Atrial Fibrillation Patients in France

Abstract

feasibility of combined neuroprotection in patients with AIS convincingly are substantiated by leading Ukrainian neurologists. The aim is to evaluate the economic feasibility of combined regimens of neuroprotection compared with the traditional. METHODS: Analysis of the results of comparative clinical trial of three neuroprotective regimens therapy of patients with moderate and severe AIS: traditional ϩ citicoline (1 regimen); traditional ϩ citicoline ϩ actovegin (2 regimen); 3 regimen: traditional (pentoxifylline, heparin, acetylsalicylic acid, mannitol) (S. M. Vinychuk, O. A. Pustova, V.O. Mokchnach et al., 2008) was carried out. Cost-effectiveness analysis was used. Using a decision tree comparing the economic burden of the three regimens for one year was carried out. RESULTS: The number of patients who recovered completely after three months were used as efficacy. The efficacy for 1, 2 and 3 regimens were respectively 29.6%, 38.9% and 23.3%. Direct costs of the treatment regimens were $ 1.015; $ 1.186; $ 617 for 1, 2 and 3 regimens, respectively. Incremental cost-effectiveness ratio (ICER) for 1 and 2 regimens were respectively $6.317, $3.647. The economic burden per one patient for one year were $ 7006; $ 6511; and $ 6930 for 1, 2 and 3 regimens, respectively. CONCLUSIONS: The use of regimen 1 and regimen 2 provides greater efficacy and needs greater cost. With the forecast for one year and taking into account the indirect costs the neuroprotective regimen with combination of two drugs (regimen 2) has economic advantages. OBJECTIVES:The prevalence of atrial fibrillation (AF) in France approaches one million people. The major complication associated with AF is stroke. Current anticoagulation options for stroke prevention increase the risk of hemorrhages. Objectives were to estimate the 2-year cumulative incidence and costs of hospitalizations for strokes and hemorrhages in adults hospitalized for AF and eligible for stroke prevention. METHODS: Data for patients with an AF-related hospitalization in 2008 were extracted from the French Hospital National Database (PMSI). Risk scores (i.e.CHADS2; range:0 -6) were calculated from 2006 -2008 data. Patient eligible for stroke prevention with anti-coagulants (i.e.CHADS2Ն1) were selected for the follow-up analysis. Strokes and hemorrhages hospitalizations were identified according to ICD-10 codes. Strokes severity was based on rehabilitation length and death. Cumulative incidence was calculated by the number of new hospitalizations during the 2-year period divided by the number of patients. Mean hospital costs were calculated from to the 2011 National Hospital Tariff for acute and rehabilitation care. RESULTS: A total of 61,582 AF patients were identified. Mean age was 75.0(Ϯ11.0) years old and mean CHADS2 was 1.90(Ϯ0.99). 2-year cumulative incidences of any strokes and hemorrhages were 3.21% (ischemic/60%; hemorrhagic/ 24%; unspecified/16%) and 5.31% (gastro-intestinal/26%; intracranial/5%; others/ 69%), respectively. Mean costs of ischemic and hemorrhagic strokes w...