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
Paul Dorian,Thitima Kongnakorn,Hemant Phatak,Dale Rublee,Andreas Kuznik,Tereza Lanitis,Larry Z. Liu,Uchenna H. Iloeje,Luis Hernandez,Gregory Y.H. Lip +9 more
TL;DR: Based on randomized trial data, apixaban is a cost-effective alternative to warfarin and aspirin, in VKA suitable and VKA unsuitable patients with AF, respectively.
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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.
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