Nahid Hatam1, Jamshid Bahmei2, Khosro Keshavarz3, Farnia Feiz4, Reihaneh Sedghi4, Afshin Borhani-Haghighi5. 1. Professor of Health Administration, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran. 2. MSc in Health Care Services Management, Department of Health Economics, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran. 3. Assistant professor of Health Economics, Department of Health Economics, School of Management and Medical Information Sciences, Shiraz University of Medical Science, Shiraz, Iran. 4. Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. 5. Professor of Neurology, Clinical Neurology Research Center and Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran.
Abstract
BACKGROUND:Patients with atrial fibrillation (AF) make a unique group of strokes. Unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) are among the medications used for preventing blood coagulation. This study was carried out aiming at analyzing the cost effectiveness of LMWH versus UFH in hospitalized patients with stroke due to AF with respect to the Iranian population. METHODS: This randomized study was an economic evaluation of cost effectiveness with the help of the cross-sectional data of 2013-2015. In this study, 74 patients had undergone treatment in two groups, before being evaluated. Half of the patients were treated by LMWH, while the other half was treated by UFH. Effectiveness criterion was prevention of new stroke recurrence. RESULTS:Average medical direct costs, non-medical direct costs, and indirect costs of UFH were 110375 ± 40411$, 15594 ± 11511$, and 21723 ± 19933$, respectively. Same average medical direct costs, non-medical direct costs, and indirect costs of LMWH were 99573 ± 59143$, 9016 ± 17156$, and 10385 ± 10598$, respectively. The number of prevention of new strokes due to AF in LMWH and UFH was 2 and 0, respectively. Expected effectiveness in LMWH and UFH groups was 0.56 and 0.51, respectively. Moreover, the expected costs were 26737.61$ and 30776.18$, respectively. The incremental cost-effectiveness ratio for stroke due to AF was -150, 201, 26$ per prevention of stroke recurrence (p-values ≤ 0/05). CONCLUSION: The results of the cost-effectiveness analysis of LMWH versus UFH showed that LMWH is a dominant strategy for patients with stroke due to AF in Iranian population.
RCT Entities:
BACKGROUND:Patients with atrial fibrillation (AF) make a unique group of strokes. Unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) are among the medications used for preventing blood coagulation. This study was carried out aiming at analyzing the cost effectiveness of LMWH versus UFH in hospitalized patients with stroke due to AF with respect to the Iranian population. METHODS: This randomized study was an economic evaluation of cost effectiveness with the help of the cross-sectional data of 2013-2015. In this study, 74 patients had undergone treatment in two groups, before being evaluated. Half of the patients were treated by LMWH, while the other half was treated by UFH. Effectiveness criterion was prevention of new stroke recurrence. RESULTS: Average medical direct costs, non-medical direct costs, and indirect costs of UFH were 110375 ± 40411$, 15594 ± 11511$, and 21723 ± 19933$, respectively. Same average medical direct costs, non-medical direct costs, and indirect costs of LMWH were 99573 ± 59143$, 9016 ± 17156$, and 10385 ± 10598$, respectively. The number of prevention of new strokes due to AF in LMWH and UFH was 2 and 0, respectively. Expected effectiveness in LMWH and UFH groups was 0.56 and 0.51, respectively. Moreover, the expected costs were 26737.61$ and 30776.18$, respectively. The incremental cost-effectiveness ratio for stroke due to AF was -150, 201, 26$ per prevention of stroke recurrence (p-values ≤ 0/05). CONCLUSION: The results of the cost-effectiveness analysis of LMWH versus UFH showed that LMWH is a dominant strategy for patients with stroke due to AF in Iranian population.
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