کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
989312 935426 2013 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Cost-Effectiveness of New Oral Anticoagulants Compared with Warfarin in Preventing Stroke and Other Cardiovascular Events in Patients with Atrial Fibrillation
ترجمه فارسی عنوان
اثربخشی هزینه های ضد انعقاد خوراکی جدید در مقایسه با وارفارین در جلوگیری از سکته مغزی و سایر رویدادهای قلب و عروق در بیماران مبتلا به فیبریلاسیون دهلیزی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پزشکی و دندانپزشکی (عمومی)
چکیده انگلیسی

ObjectivesThe primary objective was to assess the cost-effectiveness of new oral anticoagulants compared with warfarin in patients with nonvalvular atrial fibrillation. Secondary objectives related to assessing the cost-effectiveness of new oral anticoagulants stratified by center-specific time in therapeutic range, age, and CHADS2 score.MethodsCost-effectiveness was assessed by the incremental cost per quality-adjusted life-year (QALY) gained. Analysis used a Markov cohort model that followed patients from initiation of pharmacotherapy to death. Transition probabilities were obtained from a concurrent network meta-analysis. Utility values and costs were obtained from published data. Numerous deterministic sensitivity analyses and probabilistic analysis were conducted.ResultsThe incremental cost per QALY gained for dabigatran 150 mg versus warfarin was $20,797. Apixaban produced equal QALYs at a higher cost. Dabigatran 110 mg and rivaroxaban were dominated by dabigatran 150 mg and apixaban. Results were sensitive to the drug costs of apixaban, the time horizon adopted, and the consequences from major and minor bleeds with dabigatran. Results varied by a center’s average time in therapeutic range, a patient’s CHADS2 score, and patient age, with either dabigatran 150 mg or apixaban being optimal.ConclusionsResults were highly sensitive to patient characteristics. Rivaroxaban and dabigatran 110 mg were unlikely to be cost-effective. For different characteristics, apixaban or dabigatran 150 mg were optimal. Thus, the choice between these two options may come down to the price of apixaban and further evidence on the impact of major and minor bleeds with dabigatran.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Value in Health - Volume 16, Issue 4, June 2013, Pages 498–506
نویسندگان
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