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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Jonathan A C Sterne,Pritesh N Bodalia,Peter Bryden,Philippa Davies,José A López-López,G N Okoli,Howard Thom,Deborah M Caldwell,Sofia Dias,Diane Eaton,Julian P T Higgins,William Hollingworth,Chris Salisbury,Jelena Savović,Reecha Sofat,Annya Stephens-Boal,Nicky J Welton,Aroon D. Hingorani +17 more
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Cost-effectiveness of apixaban vs. current standard of care for stroke prevention in patients with atrial fibrillation
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Trends in Hospitalization for Atrial Fibrillation: Epidemiology, Cost, and Implications for the Future
Azfar Sheikh,Nileshkumar J. Patel,Nikhil Nalluri,Kanishk Agnihotri,Jonathan Spagnola,Aashay Patel,Deepak Asti,Ritesh Kanotra,Hafiz Khan,Chirag Savani,Shilpkumar Arora,Nilay Patel,Badal Thakkar,Neil Patel,Dhaval Pau,Apurva Badheka,Abhishek Deshmukh,Marcin Kowalski,Juan F. Viles-Gonzalez,Hakan Paydak +19 more
TL;DR: The trends in epidemiology, hospitalization, and cost of AF are reviewed along with its future implications on public health.
References
More filters
Journal ArticleDOI
Preference-Based EQ-5D Index Scores for Chronic Conditions in the United States:
TL;DR: This research provides nationally representative, communitybased EQ-5D index scores associated with a wide variety of chronic ICD-9 codes that can be used to estimate quality-adjusted life-years in cost-effectiveness analyses.
Journal ArticleDOI
Long-term survival after first-ever stroke: the Oxfordshire Community Stroke Project.
TL;DR: Predictably, older patients had a worse absolute survival but, relative to the general population, stroke also increased the relative risk of dying in younger patients, which highlights the importance of long-term secondary prevention of vascular events in stroke patients.
Journal ArticleDOI
Prognosis after initial myocardial infarction: the Framingham study
William B. Kannel,William B. Kannel,Paul Sorlie,Paul Sorlie,Patricia M. McNamara,Patricia M. McNamara +5 more
TL;DR: Women were more prone to death and reinfarction than men during 20 years of follow-up in the Framingham cohort, chiefly because of a higher early mortality rate in women.
Journal ArticleDOI
Effect of Study Setting on Anticoagulation Control* A Systematic Review and Metaregression
TL;DR: In this article, the authors identified 67 studies with 123 patient groups having 50,208 patients followed for a total of 57,154.7 patient-years and found that patients who have received anticoagulation therapy spend a significant proportion of their time with an INR out of the therapeutic range.
Deaths: final data for 2008.
TL;DR: The decline of the age-adjusted death rate to a record low value for the United States and the increase in life expectancy to arecord high value of 78.1 years are consistent with long-term trends in mortality.
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