Gonzalo Barón Esquivias1, Ginés Escolar Albaladejo2, José Luis Zamorano3, Lourdes Betegón Nicolás4, Cristina Canal Fontcuberta4, Marina de Salas-Cansado5, Darío Rubio-Rodríguez6, Carlos Rubio-Terrés7. 1. Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Sevilla, Spain. 2. Servicio de Hemoterapia y Hemostasia, Hospital Clínic, Barcelona, Spain. 3. Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, Spain. 4. Departamento de Economía de la Salud, Bristol-Myers Squibb España, Madrid, Spain. 5. Departamento de Farmacoeconomía y Resultados en Salud, Pfizer España, Madrid, Spain. 6. Health Value, Madrid, Spain. 7. Health Value, Madrid, Spain. Electronic address: crubioterres@healthvalue.org.
Abstract
INTRODUCTION AND OBJECTIVES: Cost-effectiveness analysis of apixaban (5 mg twice daily) vs acenocoumarol (5mg/day) in the prevention of stroke in patients with nonvalvular atrial fibrillation in Spain. METHODS: Markov model covering the patient's entire lifespan with 10 health states. Data on the efficacy and safety of the drugs were provided by the ARISTOTLE trial. Warfarin and acenocoumarol were assumed to have therapeutic equivalence. PERSPECTIVES: The Spanish National Health System and society. Information on the cost of the drugs, complications, and the management of the disease was obtained from Spanish sources. RESULTS: In a cohort of 1000 patients with nonvalvular atrial fibrillation, administration of apixaban rather than acenocoumarol would avoid 18 strokes, 71 hemorrhages (28 intracranial or major), 2 myocardial infarctions, 1 systemic embolism, and 23 related deaths. Apixaban would prolong life (by 0.187 years) and result in more quality-adjusted life years (by 0.194 years) per patient. With apixaban, the incremental costs for the Spanish National Health System and for society would be € 2,488 and € 1,826 per patient, respectively. Consequently, the costs per life year gained would be € 13,305 and € 9,765 and the costs per quality-adjusted life year gained would be € 12,825 and € 9,412 for the Spanish National Health System and for society, respectively. The stability of the baseline case was confirmed by sensitivity analyses. CONCLUSIONS: According to this analysis, apixaban may be cost-effective in the prevention of stroke in patients with nonvalvular atrial fibrillation compared with acenocoumarol.
INTRODUCTION AND OBJECTIVES: Cost-effectiveness analysis of apixaban (5 mg twice daily) vs acenocoumarol (5mg/day) in the prevention of stroke in patients with nonvalvular atrial fibrillation in Spain. METHODS: Markov model covering the patient's entire lifespan with 10 health states. Data on the efficacy and safety of the drugs were provided by the ARISTOTLE trial. Warfarin and acenocoumarol were assumed to have therapeutic equivalence. PERSPECTIVES: The Spanish National Health System and society. Information on the cost of the drugs, complications, and the management of the disease was obtained from Spanish sources. RESULTS: In a cohort of 1000 patients with nonvalvular atrial fibrillation, administration of apixaban rather than acenocoumarol would avoid 18 strokes, 71 hemorrhages (28 intracranial or major), 2 myocardial infarctions, 1 systemic embolism, and 23 related deaths. Apixaban would prolong life (by 0.187 years) and result in more quality-adjusted life years (by 0.194 years) per patient. With apixaban, the incremental costs for the Spanish National Health System and for society would be € 2,488 and € 1,826 per patient, respectively. Consequently, the costs per life year gained would be € 13,305 and € 9,765 and the costs per quality-adjusted life year gained would be € 12,825 and € 9,412 for the Spanish National Health System and for society, respectively. The stability of the baseline case was confirmed by sensitivity analyses. CONCLUSIONS: According to this analysis, apixaban may be cost-effective in the prevention of stroke in patients with nonvalvular atrial fibrillation compared with acenocoumarol.
Authors: Klaus K Witte; Georgios Tsivgoulis; Matthew R Reynolds; Stelios I Tsintzos; Simon Eggington; Eleni Ismyrloglou; Julie Lyon; Marianne Huynh; Marta Egea; Bonnie de Brouwer; Paul D Ziegler; Noreli Franco; Rashmi Joglekar; Sarah C Rosemas; Shufeng Liu; Vincent Thijs Journal: BMC Cardiovasc Disord Date: 2021-03-31 Impact factor: 2.298
Authors: Itziar Oyagüez; Carmen Suárez; José Luis López-Sendón; José Ramón González-Juanatey; Fernando de Andrés-Nogales; Jorge Suárez; Carlos Polanco; Javier Soto Journal: Pharmacoecon Open Date: 2020-09
Authors: M Rosa Dalmau Llorca; Carina Aguilar Martín; Noèlia Carrasco-Querol; Zojaina Hernández Rojas; Emma Forcadell Drago; Dolores Rodríguez Cumplido; Elisabet Castro Blanco; Alessandra Queiroga Gonçalves; José Fernández-Sáez Journal: Int J Environ Res Public Health Date: 2021-05-26 Impact factor: 3.390