Cost-Effectiveness of Apixaban, Dabigatran, Rivaroxaban, and Warfarin for Stroke Prevention in Atrial Fibrillation
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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Journal ArticleDOI
Rivaroxaban vs Warfarin Sodium in the Ultra-Early Period After Atrial Fibrillation-Related Mild Ischemic Stroke: A Randomized Clinical Trial.
Keun-Sik Hong,Sun U. Kwon,Sang Hun Lee,Ji Sung Lee,Yong-Jae Kim,Tae Jin Song,Young Dae Kim,Man-Seok Park,Eung-Gyu Kim,Jae-Kwan Cha,Sang Min Sung,Byung-Woo Yoon,Oh Young Bang,Woo-Keun Seo,Yang-Ha Hwang,Seong Hwan Ahn,Dong-Wha Kang,Hyun Goo Kang,Kyung-Ho Yu +18 more
TL;DR: In mild AF-related acute ischemic stroke, rivaroxaban and warfarin had comparable safety and efficacy, and hospitalization length was reduced with rivroxaban compared withwarfarin.
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Estimation of the impact of warfarin’s time-in-therapeutic range on stroke and major bleeding rates and its influence on the medical cost avoidance associated with novel oral anticoagulant use-learnings from ARISTOTLE, ROCKET-AF, and RE-LY trials
Alpesh Amin,Steve Deitelzweig,Yonghua Jing,Dinara Makenbaeva,Daniel Wiederkehr,Jay Lin,John Graham +6 more
TL;DR: Among NVAF patients there is a significant negative correlation between warfarin’s TTR and SSE rate, but not major bleedings, and the economic comparison of use of individual NOACs versus warFarin.
Journal ArticleDOI
Stroke prevention in patients with atrial fibrillation in France: comparative cost-effectiveness of new oral anticoagulants (apixaban, dabigatran, and rivaroxaban), warfarin, and aspirin
T. Lanitis,François-Emery Cotté,Anne-Françoise Gaudin,I. Kachaner,T. Kongnakorn,Isabelle Durand-Zaleski +5 more
TL;DR: An economic evaluation of the currently prescribed treatments for stroke prevention in patients with non-valvular atrial fibrillation including warfarin, aspirin, and novel oral anticoagulants from a French payer perspective found apixaban as a less costly yet more effective treatment alternative.
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Direct oral anticoagulants: analysis of worldwide use and popularity using Google Trends.
TL;DR: The results of this analysis suggest that the popularity of DOACs is constantly increasing around the world, whereas that of warfarin has exhibited a constant and inexorable decline.
Journal ArticleDOI
Apixaban, dabigatran, and rivaroxaban versus warfarin for stroke prevention in non-valvular atrial fibrillation: a cost-effectiveness analysis.
TL;DR: The analysis suggests that NOAs are a cost-effective treatment for the prevention of stroke in patients with NVAF in the Italian healthcare setting.
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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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