Implementing Guidelines: The Cost and Clinical Impact of Anticoagulants in the UK Atrial Fibrillation Population

Applied Health Economics and Health Policy

Volumn 13, Issue 5, 2015, Pages 543-551

  Shields, Gemma E ^a   Bates, Alexander E ^b   Chapman, Ann Marie ^a  

^a BRESMED   (United Kingdom)

^b Yorkshire and Humber Commissioning Support Unit Douglas Mill   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ANTICOAGULANT AGENT;

ANTICOAGULANT THERAPY; ARTICLE; ATRIAL FIBRILLATION; BRAIN HEMORRHAGE; BRAIN ISCHEMIA; CEREBROVASCULAR ACCIDENT; COST EFFECTIVENESS ANALYSIS; HEALTH CARE COST; HEALTH CARE PLANNING; HEALTH IMPACT ASSESSMENT; HUMAN; MAJOR CLINICAL STUDY; MORTALITY; OUTCOME ASSESSMENT; OUTCOMES RESEARCH; PRACTICE GUIDELINE; PRIMARY PREVENTION; RESOURCE MANAGEMENT; RISK ASSESSMENT; UNITED KINGDOM; AGED; COST BENEFIT ANALYSIS; DRUG COST; ECONOMICS; FEMALE; GREAT BRITAIN; MALE; MIDDLE AGED; RISK FACTOR; STATISTICAL MODEL; STATISTICS AND NUMERICAL DATA; STROKE;

AGED; ANTICOAGULANTS; ATRIAL FIBRILLATION; COST-BENEFIT ANALYSIS; DRUG COSTS; FEMALE; GREAT BRITAIN; GUIDELINE ADHERENCE; HEALTH CARE COSTS; HUMANS; MALE; MIDDLE AGED; MODELS, ECONOMIC; RISK FACTORS; STROKE;

EID: 84942373295     PISSN: 11755652     EISSN: 11791896     Source Type: Journal    
DOI: 10.1007/s40258-015-0180-7     Document Type: Article

References (45)

1. National Institute for Health and Care Excellence. Atrial fibrillation: the management of atrial fibrillation. 2014. http://www.nice.org.uk/guidance/cg180. Accessed 20 Feb 2015.
2. British Heart Foundation. Atrial fibrillation. 2014. http://www.bhf.org.uk/heart-health/conditions/atrial-fibrillation.aspx. Accessed 20 Feb 2015.
3. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. 1991;22(8):983–8.
4. British Heart Foundation. Stroke and your heart. 2014. https://www.bhf.org.uk/heart-health/conditions/stroke. Accessed 20 Mar 2015.
5. Kannel WB, Wolf PA, Benjamin EJ, Levy D. Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol. 1998;82(8a):2n–9n.
6. World Health Organization. Global burden of stroke. In: The atlas of heart disease and stroke. 2004. http://www.who.int/cardiovascular_diseases/en/cvd_atlas_15_burden_stroke.pdf. Accessed 20 Feb 2015.
7. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation: a major contributor to stroke in the elderly. The Framingham Study. Arch Intern Med. 1987;147(9):1561–4.
8. Lamassa M, Di Carlo A, Pracucci G, Basile AM, Trefoloni G, Vanni P, et al. Characteristics, outcome, and care of stroke associated with atrial fibrillation in Europe: data from a multicenter multinational hospital-based registry (The European Community Stroke Project). Stroke. 2001;32(2):392–8.
9. Bruggenjurgen B, Rossnagel K, Roll S, Andersson FL, Selim D, Muller-Nordhorn J, et al. The impact of atrial fibrillation on the cost of stroke: the berlin acute stroke study. Value Health. 2007;10(2):137–43. doi:10.1111/j.1524-4733.2006.00160.x.
10. Verheugt FW. Good old warfarin for stroke prevention in atrial fibrillation. Lancet. 2006;367(9526):1877–8. doi:10.1016/s0140-6736(06)68819-3.
11. Royal College of Physicians Clinical Effectiveness and Evaluation Unit. Sentinel Stroke National Audit Programme (SSNAP). Clinical audit first pilot public report. 2013. https://www.rcplondon.ac.uk/sites/default/files/ssnap_first_pilot_national_report_january_-_march_2013_admissions_with_appendices_.pdf. Accessed 20 Feb 2015.
12. Neidecker M, Patel A, Nelson W, Reardon G. Use of warfarin in long-term care: a systematic review. BMC Geriatr. 2012;12(1):1–33. doi:10.1186/1471-2318-12-14.
13. National Institute for Health and Care Excellence. Anticoagulation—oral. Scenario: Warfarin. In: Clinical knowledge summaries. 2015. http://cks.nice.org.uk/anticoagulation-oral#!scenario:3. Accessed 8 May 2015.
14. National Institute for Health and Care Excellence Implementation Collaboration. Consensus. Supporting local implementation of NICE guidance on use of the novel (non-Vitamin K antagonist) oral anticoagulants in non-valvular atrial fibrillation. https://www.nice.org.uk/guidance/cg180/resources/cg180-atrial-fibrillation-nic-consensus-statement-on-the-use-of-noacs22014. Accessed 14 March 2015.
15. Antipolis S. Aspirin still overprescribed for stroke prevention in AF. In: 2014 General Press releases. European Society of Cardiology. 2014. http://www.escardio.org/about/press/press-releases/pr-14/Pages/aspirin-overprescribed-stroke-afib.aspx. Accessed 17 Feb 2015.
16. Kansal AR, Sorensen SV, Gani R, Robinson P, Pan F, Plumb JM, et al. Cost-effectiveness of dabigatran etexilate for the prevention of stroke and systemic embolism in UK patients with atrial fibrillation. Heart. 2012;98(7):573–8. doi:10.1136/heartjnl-2011-300646.
17. Dorian P, Kongnakorn T, Phatak H, Rublee DA, Kuznik A, Lanitis T et al. Cost-effectiveness of apixaban vs. current standard of care for stroke prevention in patients with atrial fibrillation. Eur Heart J. 2014;35:1897–1906.
18. Zheng Y, Sorensen SV, Gonschior AK, Noack H, Heinrich-Nols J, Sunderland T et al. Comparison of the cost-effectiveness of new oral anticoagulants for the prevention of stroke and systemic embolism in atrial fibrillation in a UK setting. Clinical therapeutics. 2014;36(12):2015–28.e2. doi:10.1016/j.clinthera.2014.09.015.
19. Jowett S, Bryan S, Mant J, Fletcher K, Roalfe A, Fitzmaurice D, et al. Cost effectiveness of warfarin versus aspirin in patients older than 75 years with atrial fibrillation. Stroke. 2011;42(6):1717–21. doi:10.1161/strokeaha.110.600767.
20. National Institute for Health and Care Excellence. Advice from NICE supports improved commissioning for anticoagulation therapy for adults. In: Press release archive. 2013. http://www.nice.org.uk/news/press-and-media/advice-from-nice-supports-improved-commissioning-for-anticoagulation-therapy-for-adults. Accessed 5 Feb 2015.
21. Mauskopf JA, Earnshaw S, Mullins CD. Budget impact analysis: review of the state of the art. Exp Rev Pharmacoecon Outcomes Res. 2005;5(1):65–79. doi:10.1586/14737167.5.1.65.
22. Sullivan SD, Mauskopf JA, Augustovski F, Jaime Caro J, Lee KM, Minchin M, et al. Budget impact analysis—principles of good practice: Report of the ISPOR 2012 Budget Impact Analysis Good Practice II Task Force. Value Health. 2014;17(1):5–14. doi:10.1016/j.jval.2013.08.2291.
23. Office of National Statistics. Annual mid-year population estimates for Clinical Commissioning Groups. 2011. http://www.ons.gov.uk/ons/rel/sape/clinical-commissioning-group-population-estimates/mid-2011–census-based-/stb—clinical-commissioning-groups—mid-2011.html. Accessed 16 May 2015.
24. Davis RC, Hobbs FD, Kenkre JE, Roalfe AK, Iles R, Lip GY, et al. Prevalence of atrial fibrillation in the general population and in high-risk groups: the ECHOES study. Europace. 2012;14(11):1553–9. doi:10.1093/europace/eus087.
25. Office of National Statistics. Clinical commissioning group population estimates. 2013. Clinical Commissioning Group Population Estimates. http://www.ons.gov.uk/ons/rel/sape/clinical-commissioning-group-populationestimates/mid-2011--census-based-/index.html. Accessed 6 May 2015.
26. Heeringa J, van der Kuip DA, Hofman A, Kors JA, van Herpen G, Stricker BH, et al. Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. Eur Heart J. 2006;27(8):949–53. doi:10.1093/eurheartj/ehi825.
27. National Institute for Health and Care Excellence. CG180 atrial fibrillation (update): costing template. 2014. https://www.nice.org.uk/guidance/cg180/resources/cg180-atrial-fibrillation-update-costing-template. Accessed 16 May 2015.
28. Crowther MA, Warkentin TE. Bleeding risk and the management of bleeding complications in patients undergoing anticoagulant therapy: focus on new anticoagulant agents. Blood. 2008;111(10):4871–9. doi:10.1182/blood-2007-10-120543.
29. Heidbuchel H, Verhamme P, Alings M, Antz M, Hacke W, Oldgren J, et al. EHRA practical guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation: executive summary. Eur Heart J. 2013;34(27):2094–106. doi:10.1093/eurheartj/eht134.
30. Connolly S, Pogue J, Hart R, Pfeffer M, Hohnloser S, Chrolavicius S, et al. Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE W): a randomised controlled trial. Lancet. 2006;367(9526):1903–12. doi:10.1016/s0140-6736(06)68845-4.
31. Mant J, Hobbs FD, Fletcher K, Roalfe A, Fitzmaurice D, Lip GY, et al. Warfarin versus aspirin for stroke prevention in an elderly community population with atrial fibrillation (the Birmingham Atrial Fibrillation Treatment of the Aged Study, BAFTA): a randomised controlled trial. Lancet. 2007;370(9586):493–503. doi:10.1016/s0140-6736(07)61233-1.
32. Miller CS, Grandi SM, Shimony A, Filion KB, Eisenberg MJ. Meta-analysis of efficacy and safety of new oral anticoagulants (dabigatran, rivaroxaban, apixaban) versus warfarin in patients with atrial fibrillation. Am J Cardiol. 2012;110(3):453–60. doi:10.1016/j.amjcard.2012.03.049.
33. No authors listed. Adjusted-dose warfarin versus low-intensity, fixed-dose warfarin plus aspirin for high-risk patients with atrial fibrillation: Stroke Prevention in Atrial Fibrillation III randomised clinical trial. Lancet. 1996;348(9028):633–8.
34. Kassianos G, Arden C, Hogan S, Dew R, Fuat A. Current management of atrial fibrillation: an observational study in NHS primary care. BMJ Open. 2013;3(11):e003004. doi:10.1136/bmjopen-2013-003004.
35. National Institute for Health and Clinical Excellence. Atrial fibrillation: the management of atrial fibrillation. In: Costing reports. https://www.nice.org.uk/guidance/cg180/costing. Accessed 16 May 2015.
36. Luengo-Fernandez R, Gray AM, Rothwell PM. Population-based study of determinants of initial secondary care costs of acute stroke in the United Kingdom. Stroke. 2006;37(10):2579–87. doi:10.1161/01.STR.0000240508.28625.2c.
37. Curtis L. Unit costs of health and social care 2014. Personal Social Services Research Unit. 2014. http://www.pssru.ac.uk/project-pages/unit-costs/2014/index.php. Accessed 13 Feb 2015.
38. National Institute for Health and Care Excellence. Stroke: diagnosis and initial management of acute stroke and transient ischaemic attack (TIA). In: Costing report. https://www.nice.org.uk/guidance/cg68/resources/stroke-costing-report. Accessed 27 Feb 2015.
39. Department of Health. NHS reference costs 2013 to 2014. National schedule of reference costs: the main schedule. 2014. https://www.gov.uk/government/publications/nhs-reference-costs-2013-to-2014. Accessed 20 Feb 2015.
40. MIMS online. Database of prescription and generic drugs. 2015. http://www.mims.co.uk/. Accessed 13 Feb 2015.
41. Connock M, Stevens C, Fry-Smith A, Jowett S, Fitzmaurice D, Moore D et al. Clinical effectiveness and cost-effectiveness of different models of managing long-term oral anticoagulation therapy: a systematic review and economic modelling. Health Technol Assess (Winch, Engl). 2007;11(38):iii-iv, ix–66.
42. Di Carlo A. Human and economic burden of stroke. Age Ageing. 2009;38(1):4–5. doi:10.1093/ageing/afn282.
43. Luengo-Fernandez R, Yiin GS, Gray AM, Rothwell PM. Population-based study of acute- and long-term care costs after stroke in patients with AF. Int J Stroke. 2013;8(5):308–14. doi:10.1111/j.1747-4949.2012.00812.x.
44. Guerrouij M, Uppal CS, Alklabi A, Douketis JD. The clinical impact of bleeding during oral anticoagulant therapy: assessment of morbidity, mortality and post-bleed anticoagulant management. J Thromb Thrombolysis. 2011;31(4):419–23. doi:10.1007/s11239-010-0536-7.
45. Heneghan C, Ward A, Perera R, Bankhead C, Fuller A, Stevens R, et al. Self-monitoring of oral anticoagulation: systematic review and meta-analysis of individual patient data. Lancet. 2012;379(9813):322–34. doi:10.1016/s0140-6736(11)61294-4.