Value in Health最新文献

{"title":"Economic Evaluations of Interventions Addressing Inequalities in Cancer Care: A Systematic Review","authors":"Bedasa Taye Merga MPH ,&nbsp;Nikki McCaffrey PhD ,&nbsp;Suzanne Robinson PhD ,&nbsp;Ebisa Turi MPH ,&nbsp;Anita Lal PhD","doi":"10.1016/j.jval.2024.09.010","DOIUrl":"10.1016/j.jval.2024.09.010","url":null,"abstract":"<div><h3>Objectives</h3><div>Although substantial evidence exists on the costs and benefits of cancer care and screening programs for the general population, economic evidence of interventions addressing inequalities is less well known. This systematic review summarized economic evaluations of interventions addressing inequalities in cancer screening and care to inform decision makers on the value for money of such interventions.</div></div><div><h3>Methods</h3><div>Embase, MEDLINE, Cochrane Library, EconLit, and Scopus databases were searched for studies published from database inception to October 27, 2023. Studies were eligible for inclusion if they were economic evaluations of interventions to improve or address inequalities in cancer care among disadvantaged population groups. Study characteristics and cost-effectiveness results (US dollars 2023) were summarized. Study quality was assessed by 2 authors using the Drummond checklist.</div></div><div><h3>Results</h3><div>The searches yielded 2937 records, with 30 meeting the eligibility criteria for data extraction. In most of the studies (n = 27, 90%), interventions were considered cost-effective in addressing inequalities in cancer care and screening among disadvantaged populations. Notably, 60% of the studies were rated as high quality, 33.3% as good, and 6.7% as fair quality.</div></div><div><h3>Conclusions</h3><div>This systematic review identified cost-effective strategies addressing inequalities in cancer screening and care that have the potential to be replicated in other locations. The interventions were mainly focused on screening programs, and few addressed equity gaps around risk reduction and diagnostic and treatment outcomes. This underscores the need for targeted approaches to address inequalities in under-researched priority population groups along the cancer care continuum.</div></div>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":"28 2","pages":"Pages 306-318"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review and Quality Assessment of Cardiovascular Disease–Specific Health-Related Quality-of-Life Instruments: Part II Psychometric Properties","authors":"Xue Li PhD ,&nbsp;Rui Li MSc ,&nbsp;Meixuan Li MSc ,&nbsp;Xu Hui MSc ,&nbsp;Jing Li MSc ,&nbsp;Liang Yao PhD ,&nbsp;Harriette Van Spall MD, MPH ,&nbsp;Kun Zhao PhD ,&nbsp;Qiang Fu PhD ,&nbsp;Feng Xie PhD","doi":"10.1016/j.jval.2024.08.011","DOIUrl":"10.1016/j.jval.2024.08.011","url":null,"abstract":"<div><h3>Objectives</h3><div>Health-related quality-of-life instruments for cardiovascular diseases (CVDs) have been commonly used to measure important patient-reported outcomes in clinical trials and practices. This study aimed to systematically identify and evaluate the psychometric properties of CVD-specific health-related quality-of-life instruments.</div></div><div><h3>Methods</h3><div>We searched cumulative index to nursing and allied health literature, Embase, and PubMed from inception to January 20, 2022. Studies that reported psychometric properties of CVD-specific instruments were included. Two reviewers independently assessed the methodological quality using the Consensus-based Standards for the Selection of Health Measurement Instruments methods for evaluating measurement properties and quality of evidence. Seven psychometric properties, including structural validity, internal consistency, test-retest reliability, convergent validity, divergent validity, discriminative validity, and responsiveness, were evaluated.</div></div><div><h3>Results</h3><div>We identified 142 studies reporting psychometric properties of 40 instruments. Five (12.5%) instruments demonstrated measurement properties with sufficient or inconsistent ratings; 16 (40.0%) instruments did not report any responsiveness evidence. Of the 40 instruments, 15 (37.5%) instruments were rated sufficient with high quality of evidence on internal consistency; 4 (10.0%) on structural validity, convergent validity and divergent validity; and 3 (7.5%) on discriminative validity.</div></div><div><h3>Conclusions</h3><div>When measuring patient-reported outcomes in clinical trials or routine practice, it is important to choose instruments with established psychometric properties.</div></div>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":"28 2","pages":"Pages 294-305"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Application of the Checklist for Health Economic Quality Evaluations in a Systematic Review Setting","authors":"Stijntje W. Dijk MD, MSc ,&nbsp;Skander Essafi MD ,&nbsp;Myriam G.M. Hunink MD, PhD","doi":"10.1016/j.jval.2024.10.3853","DOIUrl":"10.1016/j.jval.2024.10.3853","url":null,"abstract":"<div><h3>Objective</h3><div>Quality assessment tools serve an important role in evaluating economic evaluations. This article showcases the first application of the Checklist for Health Economic Quality Evaluations (CHEQUE) tool in a systematic review setting and offers descriptive reflections on its use.</div></div><div><h3>Methods</h3><div>We applied CHEQUE to 21 diverse economic evaluations in a systematic review of medical education. We visualized weighted CHEQUE scores, calculate correlations between methods and reporting sections, and provided all data and R code for reuse in future applications. Finally, we provided a detailed overview of our judgments and alternative considerations of the checklist items, and suggestions for further development.</div></div><div><h3>Results</h3><div>Scores ranged from 18% to 94% depending on the applied weighting method, with a positive correlation between the method and reporting quality. CHEQUE enables systematic and standardized assessment but may benefit from refinement in scoring clarity and burden reduction.</div></div><div><h3>Conclusion</h3><div>Our study provides insights for future guidance on applying and developing CHEQUE or similar tools in economic evaluation quality assessment.</div></div>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":"28 2","pages":"Pages 250-259"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reporting Uncertainty Around Health-State Values: A Standard Method and Worked Example","authors":"Nancy J. Devlin PhD ,&nbsp;Giselle Abangma MSc ,&nbsp;Andrew Lloyd DPhil ,&nbsp;David Parkin DPhil ,&nbsp;Andrew Briggs DPhil","doi":"10.1016/j.jval.2024.11.010","DOIUrl":"10.1016/j.jval.2024.11.010","url":null,"abstract":"<div><h3>Objectives</h3><div>Articles reporting value sets typically only report the standard errors (SEs) around each estimated coefficient in value set models. This is important information but does not help those building cost-effectiveness models, who need to know the uncertainty around the values of health states to conduct sensitivity analyses. This report’s aim is to demonstrate how SEs around health-related quality of life values can be calculated, using the example of the UK EQ-5D-3L value set.</div></div><div><h3>Methods</h3><div>We show how information from a model’s variance/covariance matrix can be used to estimate SEs for every health-state value, whether it is part of the modeling data set or not. Data from the Measurement and Valuation of Health study were used to replicate the original UK value set and the variance/covariance matrix and to produce SEs around the values for all 243 EQ-5D-3L states.</div></div><div><h3>Results</h3><div>The range of the SEs is small compared with the range of the health-state values but is conditional on a correct model specification and may be sensitive to alternative specifications.</div></div><div><h3>Conclusions</h3><div>Reporting these SEs should become routine practice in reporting value sets, to ensure that users are provided with information on parameter uncertainty. These SEs only capture one specific aspect of the sources of uncertainty around health-related quality of life values but represent a first step toward a more complete account of uncertainty in the preference weights used to estimate quality-adjusted life-years.</div></div>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":"28 2","pages":"Pages 191-196"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Cost-Effectiveness of Frontline Tyrosine Kinase Inhibitors for Patients With Chronic Myeloid Leukemia: In Pursuit of Treatment-Free Remission and Dose Reduction","authors":"Sanne J.J.P.M. Metsemakers MSc ,&nbsp;Rosella P.M.G. Hermens PhD ,&nbsp;Geneviève I.C.G. Ector PhD ,&nbsp;Nicole M.A. Blijlevens PhD ,&nbsp;Tim M. Govers PhD","doi":"10.1016/j.jval.2024.12.005","DOIUrl":"10.1016/j.jval.2024.12.005","url":null,"abstract":"<div><h3>Objectives</h3><div>The management of chronic myeloid leukemia (CML) now includes dose reduction (DR) and treatment-free remission (TFR). Evaluating the cost-effectiveness of lifelong-prescribed expensive tyrosine kinase inhibitors (TKIs) for CML is crucial. Prior cost-effectiveness evaluations state that imatinib is the favorable frontline TKI. Some of these evaluations address TFR, but not DR, nor aging and second-generation (2G)-TKIs upcoming patent expirations. This study evaluates the cost-effectiveness of frontline TKIs for CML patients including these factors.</div></div><div><h3>Methods</h3><div>This Markov model evaluates the cost-effectiveness of frontline TKIs for newly diagnosed patients with CML using 17 health states. Transition probabilities, costs, and utilities were derived from literature data. Incremental cost-effectiveness ratios were calculated. Sensitivity analysis and model validation were conducted.</div></div><div><h3>Results</h3><div>Nilotinib is most effective (20.13 quality-adjusted life-years [QALYs]) and imatinib is least effective (17.25 QALYs) for the model including TFR and DR. Imatinib was favored over dasatinib (89.80%), nilotinib (62.70%), and bosutinib (78.40%), at a willingness-to-pay threshold of €80 000 per QALY. Without TFR and DR, fewer QALYs were generated. For patients at the age of 70 years, imatinib has a high probability of being more cost-effective than dasatinib, nilotinib, and bosutinib. With 50% 2GTKI cost reductions, nilotinib is considered more cost-effective compared with imatinib (98.40%), dasatinib (94.80%), and bosutinib (68.90%).</div></div><div><h3>Conclusions</h3><div>The findings indicate that 2GTKIs are more effective in generating QALYs, including for older (age &gt;70 years) patients. Given the current TKI prices, imatinib remains cost-effective. Including DR and TFR in CML management generates more QALYs. Cost reductions from expected 2GTKIs patent expirations will greatly increase their cost-effectiveness. Results may inform 2GTKIs cost discussions after patent expiration, potentially broadening global availability. The findings also emphasize the importance of aiming for TFR and DR in CML management.</div></div>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":"28 2","pages":"Pages 224-232"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Slipping Away: Slippage in Hazard Ratios Over Datacuts and Its Impact on Immuno-oncology Combination Economic Evaluations","authors":"Dawn Lee MMath, MSc ,&nbsp;Zain Ahmad ,&nbsp;Caroline Farmer PhD ,&nbsp;Maxwell S. Barnish PhD ,&nbsp;Alan Lovell PhD ,&nbsp;G.J. Melendez-Torres DPhil, MPH, RN","doi":"10.1016/j.jval.2024.09.008","DOIUrl":"10.1016/j.jval.2024.09.008","url":null,"abstract":"<div><h3>Objectives</h3><div>This study examines the impact of slippage in hazard ratios (tending toward the null over subsequent datacuts) for overall survival for combination treatment with a PD-(L)-1 inhibitor and a tyrosine kinase inhibitor in advanced renal cell carcinoma.</div></div><div><h3>Methods</h3><div>Four trials’ Kaplan-Meier curves were digitized over several datacuts and fitted with standard parametric curves. Accuracy and consistency of early data projections were calculated versus observed restricted mean survival time and fitted lifetime survival from the longest follow-up datacut. The change in economically justifiable price (eJP) was calculated fitting the same curve to both arms, using an assumed average utility of 0.7 and willingness-to-pay threshold of £30 000 per quality-adjusted life-year. The eJP represents the lifetime justifiable price increment for the new treatment, including differences in drug-, administration-, and disease-related costs.</div></div><div><h3>Results</h3><div>Slippage in hazard ratios was observed in trials with longer follow-up, potentially influenced by subsequent PD-(L)-1 use after tyrosine kinase inhibitor monotherapy, early stoppage of PD-(L)-1, and development of resistance. Lognormal and log-logistic curves were more likely to overpredict the observed result; Gompertz and gamma underpredicted. Statistical measures of goodness of fit did not select the curves that resulted in the RMST closest to what was observed in the final data cut. Large differences in incremental mean life-years were observed between even the penultimate and final datacuts for most of the fitted curves, meaningfully affecting the eJP.</div></div><div><h3>Conclusions</h3><div>This work demonstrates the challenge in predicting treatment benefits with novel therapies using immature data. Incorporating information on the impact of subsequent treatment is likely to play a key role in improving predictions.</div></div>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":"28 2","pages":"Pages 260-268"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Recall and Timing of Assessment on the Estimation of Quality-Adjusted Life-Years When Health Fluctuates Recurrently","authors":"Sabina Sanghera PhD ,&nbsp;Joanna Coast PhD ,&nbsp;Axel Walther PhD ,&nbsp;Tim J. Peters PhD","doi":"10.1016/j.jval.2024.11.005","DOIUrl":"10.1016/j.jval.2024.11.005","url":null,"abstract":"<div><h3>Objectives</h3><div>When health fluctuates recurrently, estimating quality of life (QOL) is challenging, risking over-/underestimation due to measures’ recall periods and timing. To inform how/when to capture QOL, we compared responses using different recall periods and assessment timings.</div></div><div><h3>Methods</h3><div>For one 3-week chemotherapy cycle, cancer patients were randomly assigned to complete EQ-5D-5L or SF-12v2 (daily with a daily recall, weekly with a weekly recall, and at 3 weeks with a 3-week recall); a third group completed SF-12v2 daily with a 3-week recall. EQ-5D-5L and SF-6D utilities (anchored at 1 [full health] and 0 [dead]) were generated and repeated measures analysis of variance, <em>t</em> tests, and effect sizes were calculated to compare recall.</div></div><div><h3>Results</h3><div>A total of 503 patients consented; all 21 daily questionnaires were completed by 84 (50%), 67 (40%), and 72 (43%) in the groups. Both measures captured fluctuations in QOL suggesting differences are due to recall effects. Mean daily scores were greater than scores for the past week on days 7, 14, and 21 (<em>P</em> &lt; .0001). Utility was underestimated (by 0.0782, 0.0374, and 0.0437) for EQ-5D-5L and (0.0387, 0.0266, and 0.0304) for SF-6D, with the EQ-5D-5L comparison on day 7 reaching a minimally important difference. The “past 3 weeks” generated the lowest scores (<em>P</em> &lt; .0001), with utility underestimated by 0.0746 (EQ-5D-5L) and 0.0310 (SF-6D), heavily skewed by the first treatment week.</div></div><div><h3>Conclusions</h3><div>The current practice of using a single estimate at the beginning or end of a cycle with a daily (EQ-5D-5L) or longer (SF-12/SF-36) recall could bias cost-effectiveness estimates. QOL should be captured frequently with short recall when fluctuations are likely and less frequently with longer recall in stable periods.</div></div>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":"28 2","pages":"Pages 275-284"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Social Preferences for Health and Well-Being Across the Digital Divide: A Qualitative Investigation Based on Tasks Taken From an Online Discrete Choice Experiment","authors":"Becky Field PhD ,&nbsp;Katherine E. Smith PhD ,&nbsp;Clementine Hill O’Connor PhD ,&nbsp;Nyantara Wickramasekera MSc ,&nbsp;Aki Tsuchiya PhD","doi":"10.1016/j.jval.2024.11.001","DOIUrl":"10.1016/j.jval.2024.11.001","url":null,"abstract":"<div><h3>Objectives</h3><div>Increasingly, discrete choice experiments (DCEs) are conducted online, with little consideration of the digitally excluded, who are unable to participate. Policy makers or others considering online research data need clarity about how views might differ across this “digital divide.” We took tasks from an existing online DCE designed to elicit social preferences for health and well-being outcomes. We aimed to explore (1) how telephone interview participants answered a series of choice tasks taken from an online DCE and (2) whether and how decision making for these tasks differed between digitally excluded and nonexcluded participants.</div></div><div><h3>Methods</h3><div>We conducted semistructured telephone interviews with members of the public (n = 27), recruited via an existing social research panel. Data were analyzed thematically to identify key approaches to decision making.</div></div><div><h3>Results</h3><div>Twelve participants were classed as “digitally excluded,” and 15 as “digitally nonexcluded.” Responses were similar between the 2 samples for most choice tasks. We identified 3 approaches used to reach decisions: (1) simplifying, (2) creating explanatory narratives, and (3) personalizing. Although these approaches were common across both samples, understanding the exercise seemed more challenging for the digitally excluded sample.</div></div><div><h3>Conclusions</h3><div>This novel study provides some assurance that the participants’ views over the choice tasks used are similar across the digital divide. The challenges we identified with understanding highlight the need to carefully examine the views held by the digitally excluded. If online data are to inform policy making, it is essential to explore the views of those who cannot participate in online DCEs.</div></div>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":"28 2","pages":"Pages 285-293"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Biases in Post-Stroke Health Utility Estimates by Modified Rankin Scale Scores","authors":"Takashi Yoshioka MD, PhD","doi":"10.1016/j.jval.2024.07.028","DOIUrl":"10.1016/j.jval.2024.07.028","url":null,"abstract":"","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":"28 2","pages":"Pages 319-320"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescription Medication Use and Expenditure for Atrial Fibrillation in the United States","authors":"Harshith Thyagaturu MD ,&nbsp;Karthik Seetharam MD ,&nbsp;Nicholas Roma MD ,&nbsp;Neel Patel MD ,&nbsp;Jordan Lacoste PharmD ,&nbsp;Vikram Padala BS ,&nbsp;Karthik Gonuguntla MD ,&nbsp;Muhammad Bilal Munir MD ,&nbsp;Sudarshan Balla MD","doi":"10.1016/j.jval.2024.11.012","DOIUrl":"10.1016/j.jval.2024.11.012","url":null,"abstract":"<div><h3>Objectives</h3><div>To study the national trends of anticoagulants, antiarrhythmic drugs (AADs), and expenditures in the civilian noninstitutionalized atrial fibrillation (AF) population.</div></div><div><h3>Methods</h3><div>The Medical Expenditure Panel Survey was queried from January 2016 to December 2021 to identify adults (age ≥18 years) with a diagnosis of AF utilizing the International Classification of Diseases, Tenth Revision, Clinical Modification code I48. Prevalence of anticoagulants (AAD) and its expenditure and AF expenditure across clinical settings in the United States were estimated. The predictors of anticoagulant use were identified utilizing multivariate logistic regression analysis.</div></div><div><h3>Results</h3><div>A total of 17.3 million AF adults were identified, of which 46.5% were female, 89.6% were White, and ∼70% were middle/high income with prevalent comorbidities of hypertension (75.3%) and coronary heart disease (30%). The mean CHA₂DS₂ VASc score was 3.2, and 40% had a score of ≥4. In the United States, an average of $26 103 (2021 inflation adjusted) was spent per year per adult with AF for health-related expenditures. The prevalence of direct oral anticoagulants (DOACs) and class I AAD use has increased; in contrast, vitamin K antagonists use has declined. DOAC-related per person annual expenses increased from $849 in 2016 to $1929 in 2021. In those with a CHA₂DS₂ VASc score of ≥2, female sex and the presence of coronary heart disease were associated with a lower likelihood of anticoagulant use.</div></div><div><h3>Conclusions</h3><div>AF is a costly condition in which prescription medication use, such as DOACs and class III AADs, are significant contributors.</div></div>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":"28 2","pages":"Pages 197-205"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}