Cost-effectiveness of apixaban in non-valvular atrial fibrillation (NVAF) based on effectiveness data from a Spanish study in clinical practice (real-world evidence).
Manuel Anguita, Francisco Marín, Javier Soto, Susana Fernández de Cabo, Darío Rubio-Rodríguez, Carlos Rubio-Terrés
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引用次数: 0
Abstract
Objective: To analyze the cost-effectiveness of apixaban in the prevention ofstroke in adult patients with non-valvular atrial fibrillation (NVAF), comparedto other direct-acting oral anticoagulants (dabigatran, rivaroxaban, edoxaban)and the vitamin K antagonist acenocoumarol, based on data on effectiveness inclinical practice in Spain obtained in the FANTASIIA study.
Research design and methods: A probabilistic Markov economic model (second-order Monte Carlosimulation) was performed to analyze the costs and utilities (quality-adjustedlife years, QALYs) associated with the compared treatments, according to thedifferent probabilities of stroke, major bleeding and death observed inFANTASIIA.
Results: The cost per QALY gained in the patient treated with apixabanversus comparators ranged from €2,919 to €7,462. The probability of apixabanbeing cost-effective ranges from 91.1% (vs dabigatran 150 mg), 97.8% (vsdabigatran 110 mg), and 100% (vs. rivaroxaban, edoxaban, and acenocoumarol).
Conclusions: Based on the results of the FANTASIIA study, apixaban is acost-effective treatment (below a willingness to pay of €25,000 per QALYgained) compared to dabigatran, rivaroxaban, edoxaban, and acenocoumarol intreating patients with NVAF.
期刊介绍:
Expert Review of Cardiovascular Therapy (ISSN 1477-9072) provides expert reviews on the clinical applications of new medicines, therapeutic agents and diagnostics in cardiovascular disease. Coverage includes drug therapy, heart disease, vascular disorders, hypertension, cholesterol in cardiovascular disease, heart disease, stroke, heart failure and cardiovascular surgery. The Expert Review format is unique. Each review provides a complete overview of current thinking in a key area of research or clinical practice.