Cost-Effectiveness of Novel Oral Anticoagulants for Stroke Prevention in Non-Valvular Atrial Fibrillation

Current Cardiology Reports

Volumn 17, Issue 8, 2015, Pages

  Singh, Sheldon M ^a   Wijeysundera, Harindra C ^a,b,c  

^a UNIVERSITY OF TORONTO   (Canada)

^b UNIVERSITY OF TORONTO   (Canada)

^c INSTITUTE FOR CLINICAL EVALUATIVE SCIENCES   (Canada)

Author keywords

Anticoagulants; Atrial fibrillation; Bleeding; Cost effectiveness analysis; Stroke

Indexed keywords

ANTICOAGULANT AGENT; APIXABAN; DABIGATRAN; RIVAROXABAN; WARFARIN; PYRAZOLE DERIVATIVE; PYRIDONE DERIVATIVE;

ATRIAL FIBRILLATION; CEREBROVASCULAR ACCIDENT; CLINICAL EFFECTIVENESS; COST EFFECTIVENESS ANALYSIS; DECISION MAKING; DISEASE ASSOCIATION; DOSE RESPONSE; DRUG COST; DRUG EFFICACY; DRUG SAFETY; DRUG TOLERABILITY; DRUG WITHDRAWAL; DYSPEPSIA; HUMAN; LOW DRUG DOSE; LUNG EMBOLISM; NEUROPROTECTION; OUTCOME ASSESSMENT; QUALITY ADJUSTED LIFE YEAR; REVIEW; RISK ASSESSMENT; RISK FACTOR; RISK REDUCTION; SURVIVAL RATE; COMPLICATION; COST BENEFIT ANALYSIS; ECONOMICS; ORAL DRUG ADMINISTRATION; STROKE; TREATMENT OUTCOME;

ADMINISTRATION, ORAL; ANTICOAGULANTS; ATRIAL FIBRILLATION; COST-BENEFIT ANALYSIS; DABIGATRAN; HUMANS; PYRAZOLES; PYRIDONES; RIVAROXABAN; STROKE; TREATMENT OUTCOME; WARFARIN;

EID: 84935891526     PISSN: 15233782     EISSN: 15343170     Source Type: Journal    
DOI: 10.1007/s11886-015-0618-4     Document Type: Review

References (40)

1. Go A. Prevalence of atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA. 2001;285(18):2370–5.
2. Miyasaka Y, Barnes ME, Bersh BJ, et al. Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence. Circulation. 2006;114:119–25.
3. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. 1991;22:983–8.
4. Pan X, Simon TA, Hamilton M, et al. Comparison of costs and discharge outcomes for patients hospitalized for ischemic or hemorrhagic stroke with or without atrial fibrillation in the United States. J Thromb Thrombolysis. 2014. doi:10.1007/s11239-014-1144-8.
5. Lin HJ, Wolf PA, Kelly-Hayes M, et al. Stroke severity in atrial fibrillation. The Framingham Study. Stroke. 1996;27:1760–4.
6. Miller PS, Andersson FL, Kalra L. Are cost benefits of anticoagulation for stroke prevention in atrial fibrillation underestimated? Stroke. 2005;36:360–6.
7. Hart RG, Pearce LA, Aguilar MI. Meta-analysis: antithrombotic therapy to prevent stroke in patients with non-valvular atrial fibrillation. Ann Intern Med. 2007;146:857–67.
8. Xu Y, Holbrook AM, Simpson CS, et al. Prescribing patterns of novel oral anticoagulation following regulatory approval for atrial fibrillation in Ontario, Canada: a population-based descriptive analysis. CMAJ Open. 2013;1:E115–9.
9. Baczek VL, Chen WT, Kluger J, et al. Predictors of warfarin use in atrial fibrillation in the United States: a systematic review and metaanalysis. BMC Fam Pract. 2012;13:5.
10. Ruff CT, Giugliano RP, Braunwald E, et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomized trials. Lancet. 2014;383:955–62. This meta-analysis provides an excellent summary of the clinical benefits of NOACs from their clinical trials.
11. Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361:1139–51.
12. Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365:883–91.
13. Granger CB, Alexander JH, McMurray JJV, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365:981–92.
14. Guigliano RP, Ruff CT, Braunwald E, et al. Endoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2013;369:2093–104.
15. Verma A, Cairns JA, Mitchell LB, et al. 2014 focused update of the Canadian Cardiovascular Society guidelines for the management of atrial fibrillation. Can J Cardiol. 2014;30:1114–30. Excellent guidelines summarizing the care of patients with AF.
16. Camm AJ, Lip GYH, De Caterina R, et al. 2012 focused update of the ESC guidelines for the management of atrial fibrillation. Eur Heart J. 2012;33:2719–47.
17. HCUP Nationwide inpatient sample (NIS). Healthcare cost and utilization project (HCIP). 2007-2009. Agency for Healthcare research and quality, Rockville, MD. www.hcup-us.ahrq.gov/nisoverview.jsp. Accessed 25 Apr 2012.
18. GoodRx.com/ http://www.goodrx.com/. Accessed 2 July 2012.
19. Ontario Ministry of Health and Long Term Care. Ontario Drug Benefit (ODB) Program E-Formulary. Available at: http://www.health.gov.on.ca/english/providers/program/drugs/odbf_eformulary.html. Accessed on 2 Jan 2014.
20. McKesson Canada Catalogue July 2013.
21. Grosse SD. Assessing cost-effectiveness in healthcare: history of the $50,000 per QALY threshold. Expert Rev Pharmacoecon Outcomes Res. 2008;8:165–78.
22. Anderson JL, Heidenreich PA, Barnett PG, et al. ACC/AHA statement on cost/value methodology in clinical practice guidelines and performance measures: a report of the American College of Cardiology/American Heart Association task Force on Performance Measures and Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63:2304–22.
23. Laupacis A, Feeny D, Detsky AS, et al. How attractive does a new technology have to be to warrant adoption and utilization? Tentative guidelines for using clinical and economic evaluations. CMAJ. 1992;146:473–81.
24. Rawlins MD, Culyer AJ. National Institute for Clinical Excellence and its value judgments. BMJ. 2004;329:224–7.
25. Harrington AR, Armstrong EP, Nolan PE, Malone D. Cost-effectiveness of apixaban, dabigatran, rivaroxaban and warfarin for stroke prevention in atrial fibrillation. Stroke. 2013;44:1676–81.
26. Canestaro WJ, Patrick AR, Avron J, et al. Cost-effectiveness of oral anticoagulants for treatment of atrial fibrillation. Circ Cardiovasc Qual Outcomes. 2013;6:724–31. This is cost-effectiveness analysis from a US perspective provides an excellent analysis of its limitations. It provides an excellent framework for reading future cost-effectiveness analysis papers.
27. Coyle D, Coyle K, Cameron C, et al. Cost-effectiveness of new oral anticoagulants compared with warfarin in preventing stroke and other cardiovascular events in patients with atrial fibrillation. Value Health. 2013;16:498–506. This is cost-effectiveness analysis from a Canadian perspective provides an excellent analysis of its limitations. It provides an excellent framework for reading future cost-effectiveness analysis papers.
28. Lip GYH, Konknakorn T, Phatak H, et al. Cost-effectiveness of apixaban versus other new oral anticoagulants for stroke prevention in atrial fibrillation. Clin Ther. 2014;36:192–230.
29. Rognoni C, Marchetti M, Quaglini S, et al. Apixaban, dabigatran, and rivaroxiban versus warfarin for stroke prevention in non-valvular atrial fibrillation: a cost-effectiveness analysis. Clin Drug Investig. 2014;39:9–17.
30. Pan X, Kachroo S, Liu X, et al. Real world discontinuation rates with apixaban versus warfarin, dabigatran or rivaroxiban among atrial fibrillation patients newly initiated on anticoagulation therapy. JACC. 2014;63:A415.
31. Boehringer Ingelheim Canada Ltd. Product monograph–Pradax. January 27, 2012.
32. Briggs AH, Claxton K, Sculpher MJ. Decision modelling for health economic evaluation. Oxford: Oxford University Press; 2006.
33. Briggs AH, Weinstein MC, Fenwick EA, et al. Model parameter estimation and uncertainty analysis: a report of the ISPOR‐SMDM Modeling Good Research Practices Task Force Working Group‐6. Med Decis Making. 2012;32:722–32.
34. Drummond MF, Sculpher MJ, Torrance GW, et al. Methods for the economic evaluation of health care programmes. 3rd ed. Oxford: Oxford University Press; 2005.
35. Micieli A, Bennell MC, Pham B, et al. Identifying future research priorities using value of information analyses: left atrial occlusion devices in atrial fibrillation. J Am Heart Assoc. 2014;3, e001031. This study provides an excellent overview of value of information analyses using stroke prevention in atrial fibrillation to highlight important concepts.
36. Limone B, Bajker WL, Mearns ES, et al. Common flaws in published cost-effectiveness models of pharmacologic stroke prevention in atrial fibrillation. J Clin Epidemiol. 2014;67:1093–102. This study provides an excellent review of the limitations of cost-effectiveness analyses in atrial fibrillation.
37. Schulz KF, Chalmers I, Hayes RJ, et al. Empirical evidence of bias: dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA. 1995;273:408–12.
38. Wallentin L, Yusuf S, Ezekowitz MD, et al. Efficacy and safety of dabigatran compared with warfarin at different levels of international normalized ratio control for stroke prevention in atrial fibrillation: an analysis of the RELY trial. Lancet. 2010;376:975–83.
39. You JHS. Novel oral anticoagulants versus warfarin therapy at various levels of anticoagulation control in atrial fibrillation—a cost effectiveness analysis. J Gen Intern Med. 2013;29:438–46.
40. Singh SM, Micieli A, Wijeysundera HC. Economic evaluation of percutaneous left atrial appendage occlusion, dabigatran, and warfarin for stroke prevention in patients with nonvalvular atrial fibrillation. Circulation. 2013;127:2414–23. This study was the first to provide a framework to evaluate pharmacologic and non-pharmacologic methods of stroke reduction in patients with atrial fibrillation.