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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Comparing the Cost Effectiveness of Non-vitamin K Antagonist Oral Anticoagulants with Well-Managed Warfarin for Stroke Prevention in Atrial Fibrillation Patients at High Risk of Bleeding.
TL;DR: The results suggest that warfarin is the most cost-effective treatment for patients who can achieve a TTR of 70% and at the $US100,000/QALY willingness-to-pay threshold, which is highly sensitive to TTR.
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Safety of early initiation of rivaroxaban or dabigatran after thrombolysis in acute ischemic stroke.
Thomas Ritzenthaler,Laurent Derex,C. Davenas,W. Bnouhanna,Ahmed Farghali,Laura Mechtouff,T.-H. Cho,Norbert Nighoghossian +7 more
TL;DR: The introduction of direct oral anticoagulants in the early stage of cerebral infarction after thrombolysis may reduce the recurrence rate but raises safety concern, and the feasibility and safety of rivaroxaban or dabigatran introduction was studied.
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Latin American Clinical Epidemiology Network Series - Paper 2: Apixaban was cost-effective vs. acenocoumarol in patients with nonvalvular atrial fibrillation with moderate to severe risk of embolism in Chile.
Fernando Lanas,C. M. Castro,Carlos S. Vallejos,Luis Bustos,Catherine De La Puente,Mónica Velásquez,Carlos Zaror +6 more
TL;DR: The use of apixaban in patients with NVAF in moderate-to-high risk of stroke is cost-effective, considering the payment threshold suggested by WHO.
References
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Journal ArticleDOI
Dabigatran versus warfarin in patients with atrial fibrillation
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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
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Journal ArticleDOI
Apixaban versus Warfarin in Patients with Atrial Fibrillation
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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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