Cost-Effectiveness of Apixaban, Dabigatran, Rivaroxaban, and Warfarin for Stroke Prevention in Atrial Fibrillation
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TLDR
In patients with nonvalvular atrial fibrillation and an increased risk of stroke prophylaxis, apixaban 5 mg, dabigatran 150 mg, and rivaroxaban 20 mg were all cost-effective alternatives to warfarin.Abstract:
Background and Purpose—To estimate the cost-effectiveness of stroke prevention in patients with nonvalvular atrial fibrillation by using novel oral anticoagulants apixaban 5 mg, dabigatran 150 mg, and rivaroxaban 20 mg compared with warfarin. Methods—A Markov decision-analysis model was constructed using data from clinical trials to evaluate lifetime costs and quality-adjusted life-years of novel oral anticoagulants compared with warfarin. The modeled population was a hypothetical cohort of 70-year-old patients with nonvalvular atrial fibrillation, increased risk for stroke (CHADS2 ≥1), renal creatinine clearance ≥50 mL/min, and no previous contraindications to anticoagulation. The willingness-to-pay threshold was $50 000/quality-adjusted life-years gained. Results—In the base case, warfarin had the lowest cost of $77 813 (SD, $2223), followed by rivaroxaban 20 mg ($78 738±$1852), dabigatran 150 mg ($82 719±$1959), and apixaban 5 mg ($85 326±$1512). Apixaban 5 mg had the highest quality-adjusted life-year...read more
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References
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Journal ArticleDOI
Dabigatran versus warfarin in patients with atrial fibrillation
Stuart J. Connolly,Michael D. Ezekowitz,John W. Eikelboom,Jonas Oldgren,Amit Parekh,Janice Pogue,Paul A. Reilly,Ellison Themeles,Jeanne Varrone,Susan Wang,Marco Alings,Denis Xavier,Jun Zhu,Rafael Diaz,Basil S. Lewis,Harald Darius,Hans-Christoph Diener,Campbell D. Joyner,Lars Wallentin +18 more
TL;DR: In patients with atrial fibrillation, dabigatran given at a dose of 110 mg was associated with rates of stroke and systemic embolism that were similar to those associated with warfarin, as well as lower rates of major hemorrhage.
Journal ArticleDOI
Rivaroxaban versus Warfarin in Nonvalvular Atrial Fibrillation
Manesh R. Patel,Kenneth W. Mahaffey,Jyotsna Garg,Guohua Pan,Daniel E. Singer,Werner Hacke,Günter Breithardt,Jonathan L. Halperin,Graeme J. Hankey,Jonathan P. Piccini,Richard C. Becker,Christopher C. Nessel,John F. Paolini,Scott D. Berkowitz,Robert M. Califf +14 more
TL;DR: In patients with atrial fibrillation, rivaroxaban was noninferior to warfarin for the prevention of stroke or systemic embolism and there was no significant between-group difference in the risk of major bleeding, although intracranial and fatal bleeding occurred less frequently in the rivroxaban group.
Journal ArticleDOI
Apixaban versus Warfarin in Patients with Atrial Fibrillation
Christopher B. Granger,John H. Alexander,Renato D. Lopes,Elaine M. Hylek,Michael G. Hanna,Hussein R. Al-Khalidi,Jack Ansell,Dan Atar,Alvaro Avezum,M. Cecilia Bahit,Rafael Diaz,J. Donald Easton,Justin A. Ezekowitz,Greg C. Flaker,David A. Garcia,Margarida Geraldes,Bernard J. Gersh,Sergey P. Golitsyn,Shinya Goto,Antonio G. Hermosillo,Stefan H. Hohnloser,John D. Horowitz,Puneet Mohan,Petr Jansky,Basil S. Lewis,Jose Lopez-Sendon,Prem Pais,Alexander Parkhomenko,Jun Zhu,Lars Wallentin +29 more
TL;DR: In patients with atrial fibrillation, apixaban was superior to warfarin in preventing stroke or systemic embolism, caused less bleeding, and resulted in lower mortality.
Journal ArticleDOI
Atrial fibrillation as an independent risk factor for stroke: the Framingham Study.
TL;DR: The data suggest that the elderly are particularly vulnerable to stroke when atrial fibrillation is present, and the effects of hypertension, coronary heart disease, and cardiac failure on the risk of stroke became progressively weaker with increasing age.
Journal ArticleDOI
Heart Disease and Stroke Statistics—2011 Update A Report From the American Heart Association
Véronique L. Roger,Alan S. Go,Donald M. Lloyd-Jones,Robert J. Adams,Jarett D. Berry,Todd M. Brown,Mercedes R. Carnethon,Shifan Dai,Giovanni de Simone,Earl S. Ford,Caroline S. Fox,Heather J. Fullerton,Cathleen Gillespie,Kurt J. Greenlund,Susan M. Hailpern,John A. Heit,P. Michael Ho,Virginia J. Howard,Brett M. Kissela,Steven J. Kittner,Daniel T. Lackland,Judith H. Lichtman,Lynda D. Lisabeth,Diane M. Makuc,Gregory M. Marcus,Ariane Marelli,David B. Matchar,Mary M. McDermott,James B. Meigs,Claudia S. Moy,Dariush Mozaffarian,Michael E. Mussolino,Graham Nichol,Nina P. Paynter,Wayne D. Rosamond,Paul D. Sorlie,Randall S. Stafford,Tanya N. Turan,Melanie B. Turner,Nathan D. Wong,Judith Wylie-Rosett +40 more
TL;DR: Dariush Mozaffarian, Michael E. Mussolino, Graham Nichol, Nina P. Paynter, Wayne D. Sorlie, Randall S. Stafford, Tanya N. Turan, Melanie B. Turner, Nathan D. Turner.
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