AIMS: Patients with atrial fibrillation have a significantly increased risk of thromboembolic events such as ischaemic stroke, and patients are therefore recommended to be treated with anticoagulation treatment. The most commonly used anticoagulant consists of vitamin K antagonist such as warfarin. A new oral anticoagulation treatment, dabigatran, has recently been approved for stroke prevention among patients with atrial fibrillation. The purpose of this study was to estimate the cost-effectiveness of dabigatran as preventive treatment of stroke and thromboembolic events compared with warfarin in 65-year-old patients with atrial fibrillation in Sweden. METHODS AND RESULTS: A decision analytic simulation model was used to estimate the long-term (20-year) costs and effects of the different treatments. The outcome measures are the number of strokes prevented, life years gained, and quality-adjusted life years (QALYs) gained. Costs and effect data are adjusted to a Swedish setting. Patients below 80 years of age are assumed to start with dabigatran 150 mg twice a day and switch to 110 mg twice a day at the age of 80 years due to higher bleeding risk. The price of dabigatran in Sweden is €2.82 (Swedish kronor 25.39) per day for both doses. The cost per QALY gained for dabigatran compared with warfarin is estimated at €7742, increasing to €12 449 if dabigatran is compared with only well-controlled warfarin treatment. CONCLUSION:Dabigatran is a cost-effective treatment in Sweden, as its incremental cost-effectiveness ratio is below the normally accepted willingness to pay limit.
RCT Entities:
AIMS: Patients with atrial fibrillation have a significantly increased risk of thromboembolic events such as ischaemic stroke, and patients are therefore recommended to be treated with anticoagulation treatment. The most commonly used anticoagulant consists of vitamin K antagonist such as warfarin. A new oral anticoagulation treatment, dabigatran, has recently been approved for stroke prevention among patients with atrial fibrillation. The purpose of this study was to estimate the cost-effectiveness of dabigatran as preventive treatment of stroke and thromboembolic events compared with warfarin in 65-year-old patients with atrial fibrillation in Sweden. METHODS AND RESULTS: A decision analytic simulation model was used to estimate the long-term (20-year) costs and effects of the different treatments. The outcome measures are the number of strokes prevented, life years gained, and quality-adjusted life years (QALYs) gained. Costs and effect data are adjusted to a Swedish setting. Patients below 80 years of age are assumed to start with dabigatran 150 mg twice a day and switch to 110 mg twice a day at the age of 80 years due to higher bleeding risk. The price of dabigatran in Sweden is €2.82 (Swedish kronor 25.39) per day for both doses. The cost per QALY gained for dabigatran compared with warfarin is estimated at €7742, increasing to €12 449 if dabigatran is compared with only well-controlled warfarin treatment. CONCLUSION:Dabigatran is a cost-effective treatment in Sweden, as its incremental cost-effectiveness ratio is below the normally accepted willingness to pay limit.
Authors: Louise Justesen Hesselbjerg; Heidi Sjoelund Pedersen; Mikael Bergholdt Asmussen; Karin Dam Petersen Journal: J Med Econ Date: 2013-05-15 Impact factor: 2.448
Authors: Charalampos Kasmeridis; Stavros Apostolakis; Lars Ehlers; Lars H Rasmussen; Giuseppe Boriani; Gregory Y H Lip Journal: Pharmacoeconomics Date: 2013-11 Impact factor: 4.981
Authors: Brian M Salata; David W Hutton; Deborah A Levine; James B Froehlich; Geoffrey D Barnes Journal: Am J Cardiol Date: 2015-10-19 Impact factor: 2.778
Authors: Rickard E Malmström; Brian B Godman; Eduard Diogene; Christoph Baumgärtel; Marion Bennie; Iain Bishop; Anna Brzezinska; Anna Bucsics; Stephen Campbell; Alessandra Ferrario; Alexander E Finlayson; Jurij Fürst; Kristina Garuoliene; Miguel Gomes; Iñaki Gutiérrez-Ibarluzea; Alan Haycox; Krystyna Hviding; Harald Herholz; Mikael Hoffmann; Saira Jan; Jan Jones; Roberta Joppi; Marija Kalaba; Christina Kvalheim; Ott Laius; Irene Langner; Julie Lonsdale; Sven-Äke Lööv; Kamila Malinowska; Laura McCullagh; Ken Paterson; Vanda Markovic-Pekovic; Andrew Martin; Jutta Piessnegger; Gisbert Selke; Catherine Sermet; Steven Simoens; Cankat Tulunay; Dominik Tomek; Luka Vončina; Vera Vlahovic-Palcevski; Janet Wale; Michael Wilcock; Magdalena Wladysiuk; Menno van Woerkom; Corrine Zara; Lars L Gustafsson Journal: Front Pharmacol Date: 2013-05-14 Impact factor: 5.810