阿哌沙班治疗非瓣膜性心房颤动（NVAF）的成本-效果：基于西班牙临床实践研究的有效性数据（真实世界证据）。

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Expert Review of Cardiovascular Therapy Pub Date : 2025-01-01 Epub Date: 2025-02-17 DOI:10.1080/14779072.2025.2464180

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

摘要

目的：根据西班牙FANTASIIA研究中获得的有效性临床数据，分析阿哌沙班与其他直接作用口服抗凝剂（达比加群、利伐沙班、依多沙班）和维生素K拮抗剂阿塞诺古玛罗相比，预防成人非瓣膜性房颤（NVAF）患者卒中的成本-效果。研究设计和方法：采用概率马尔可夫经济模型（二阶蒙特卡洛模拟），根据观察到的小儿脑卒中、大出血和死亡的不同概率，分析与比较治疗相关的成本和效用（质量调整生命年，QALYs）。结果：阿哌沙班与比较药物治疗的患者获得的每个QALY成本从2,919欧元到7,462欧元不等。阿哌沙班具有成本效益的概率从91.1%（达比加群150 mg）、97.8%（达比加群110 mg）和100%（利伐沙班、依多沙班和阿塞诺古玛罗）不等。结论：基于FANTASIIA研究的结果，与达比加群、利伐沙班、依多沙班和阿塞诺库马洛治疗非瓣瓣性房颤患者相比，阿哌沙班是一种成本有效的治疗方法（低于每qaly获得25,000欧元的支付意愿）。

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Cost-effectiveness of apixaban in non-valvular atrial fibrillation (NVAF) based on effectiveness data from a Spanish study in clinical practice (real-world evidence).

Objective: To analyze the cost-effectiveness of apixaban in the prevention of stroke in adult patients with non-valvular atrial fibrillation (NVAF), compared to other direct-acting oral anticoagulants (dabigatran, rivaroxaban, edoxaban) and the vitamin K antagonist acenocoumarol, based on data on effectiveness in clinical practice in Spain obtained in the FANTASIIA study.

Research design and methods: A probabilistic Markov economic model (second-order Monte Carlo simulation) was performed to analyze the costs and utilities (quality-adjusted life years, QALYs) associated with the compared treatments, according to the different probabilities of stroke, major bleeding and death observed in FANTASIIA.

Results: The cost per QALY gained in the patient treated with apixaban versus comparators ranged from €2,919 to €7,462. The probability of apixaban being cost-effective ranges from 91.1% (vs dabigatran 150 mg), 97.8% (vs dabigatran 110 mg), and 100% (vs. rivaroxaban, edoxaban, and acenocoumarol).

Conclusions: Based on the results of the FANTASIIA study, apixaban is a cost-effective treatment (below a willingness to pay of €25,000 per QALY gained) compared to dabigatran, rivaroxaban, edoxaban, and acenocoumarol in treating patients with NVAF.

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来源期刊

Expert Review of Cardiovascular Therapy CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.70

自引率

0.00%

发文量

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.