Cost-Effectiveness of Rivaroxaban Versus Warfarin for Stroke Prevention in Atrial Fibrillation in the Belgian Healthcare Setting
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Le résumé fourni par la source
BACKGROUND: Warfarin, an inexpensive drug that has been available for over half a century, has been the mainstay of anticoagulant therapy for stroke prevention in patients with atrial fibrillation (AF). Recently, rivaroxaban, a novel oral anticoagulant (NOAC) which offers some distinct advantages over warfarin, the standard of care in a world without NOACs, has been introduced and is now recommended by international guidelines. OBJECTIVE: The aim of this study was to evaluate, from a Belgian healthcare payer perspective, the cost-effectiveness of rivaroxaban versus use of warfarin for the treatment of patients with non-valvular AF at moderate to high risk. METHODS: A Markov model was designed and populated with local cost estimates, safety-on-treatment clinical results from the pivotal phase III ROCKET AF trial and utility values obtained from the literature. RESULTS: Rivaroxaban treatment was associated with fewer ischemic strokes and systemic embolisms (0.308 vs. 0.321 events), intracranial bleeds (0.048 vs. 0.063), and myocardial infarctions (0.082 vs. 0.095) per patient compared with warfarin. Over a lifetime time horizon, rivaroxaban led to a reduction of 0.042 life-threatening events per patient, and increases of 0.111 life-years and 0.094 quality-adjusted life-years (QALYs) versus warfarin treatment. This resulted in an incremental cost-effectiveness ratio of €8,809 per QALY or €7,493 per life-year gained. These results are based on valuated data from 2010. Sensitivity analysis indicated that these results were robust and that rivaroxaban is cost-effective compared with warfarin in 87 % of cases should a willingness-to-pay threshold of €35,000/QALY gained be considered. CONCLUSIONS: The present analysis suggests that rivaroxaban is a cost-effective alternative to warfarin therapy for the prevention of stroke in patients with AF in the Belgian healthcare setting.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Cost-Effectiveness of Rivaroxaban Versus Warfarin for Stroke Prevention in Atrial Fibrillation in the Belgian Healthcare Setting
- Date Crossref
- 13/09/2013
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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KU Leuven Experimental Neurology (Department of Neurosciences) and Leuven Research Institute for Neuroscience and Disease (LIND) pays non établi dans la noticeUniversité ou école supérieure
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VIB-KU Leuven Center for Brain & Disease Research pays non établi dans la noticeStructure de recherche
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Mariaziekenhuis pays non établi dans la noticeÉtablissement de santé
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Ghent University Hospital pays non établi dans la noticeÉtablissement de santé
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Bayer (Germany) pays non établi dans la noticeEntreprise
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Bayer (Belgium) pays non établi dans la noticeEntreprise
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Deloitte Health Economics and Outcomes Research Group pays non établi dans la noticeInstitution
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Department of Pharmaceutical and Pharmacological Sciences pays non établi dans la noticeInstitution
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University Hospitals Leuven Department of Neurology pays non établi dans la noticeUniversité ou école supérieure
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Laboratory of Neurobiology pays non établi dans la noticeStructure de recherche
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Faculty of Medicine and Health Sciences Department of Internal Medicine (Cardiovascular Diseases) pays non établi dans la noticeUniversité ou école supérieure
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IMS Health pays non établi dans la noticeInstitution
Experimental Neurology (Department of Neurosciences) and Leuven Research Institute for Neuroscience and Disease (LIND) — KU Leuven, VIB-KU Leuven Center for Brain & Disease Research et Mariaziekenhuis, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.