Cost-effectiveness of apixaban vs. aspirin for the reduction of thrombo-embolism in high-risk patients with device-detected atrial fibrillation: insights from the ARTESiA trial
Rattachement africain : ca, us, gb, dk, hu, de, nl, no, se, cz, es, ch, cl. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
AIMS: Apixaban was superior to aspirin for the prevention of stroke or systemic embolism in participants with subclinical atrial fibrillation (SCAF) in the Apixaban for the Reduction of Thromboembolism in Patients With Device-Detected Subclinical Atrial Fibrillation trial. This was especially true for those with CHA2DS2-VASc score > 4. Understanding the cost-effectiveness of treating SCAF is important for decision-makers. METHODS AND RESULTS: Canadian, UK, German, and US direct healthcare costs [in 2023 US dollars (USD)] were applied to hospitalized events (including strokes and bleeds) and study drugs for all participants with a CHA2DS2-VASc score > 4 to determine the mean cost per participant during the trial (mean follow-up 3.5 years). A daily cost of $0.63, $0.11, $2.26, and $6.06 for apixaban in Canada, the UK, Germany, and the USA was used. If in-trial results were not cost-saving (below $0), the prospective plan was to perform a lifetime cost-effectiveness analysis using a Markov model and a willingness-to-pay of 50 000 USD per quality-adjusted life year (QALY). After considering the cost of study medication and clinical events over 3.5 years, apixaban was dominant (cost-saving and more effective) in Canada (-$2301) and the UK (-$902) but cost more in Germany and the USA ($600 and $1990, respectively). Over a lifetime, treatment with apixaban produced a net gain of 0.107 QALYs, but with costs in both Germany ($2623 more) and the USA ($9110 more), yielding an incremental cost-effectiveness ratio of $24 514 per QALY for Germany and $85 140 for the USA. CONCLUSION: In patients with SCAF and a CHA2DS2-VASc score > 4, apixaban is cost saving in Canada and the UK and cost-effective in Germany. Apixaban was not cost-effective in the USA under the base cost assumption but would be cost-effective at a daily cost of $4.35 and cost saving at $3.59.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Cost-effectiveness of apixaban vs. aspirin for the reduction of thrombo-embolism in high-risk patients with device-detected atrial fibrillation: insights from the ARTESiA trial
- Date Crossref
- 31/08/2025
- Éditeur
- Oxford University Press (OUP)
- 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
-
Population Health Research Institute pays non établi dans la noticeÉtablissement de santé
-
McMaster University Population Health Research Institute pays non établi dans la noticeUniversité ou école supérieure
-
University of Alberta Canadian VIGOUR Centre pays non établi dans la noticeUniversité ou école supérieure
-
University of Calgary Department of Cardiac Sciences pays non établi dans la noticeUniversité ou école supérieure
-
Canadian VIGOUR Centre pays non établi dans la noticeInstitution
-
Duke University Duke Clinical Research Institute pays non établi dans la noticeUniversité ou école supérieure
-
Clinical Research Institute pays non établi dans la noticeStructure de recherche
-
University of Liverpool pays non établi dans la noticeUniversité ou école supérieure
-
Liverpool Heart and Chest Hospital Department of Cardiology pays non établi dans la noticeÉtablissement de santé
-
Aarhus University Department of Cardiology pays non établi dans la noticeUniversité ou école supérieure
-
Aarhus University Hospital pays non établi dans la noticeÉtablissement de santé
-
Semmelweis University Heart and Vascular Center pays non établi dans la noticeUniversité ou école supérieure
Population Health Research Institute, Population Health Research Institute — McMaster University et Canadian VIGOUR Centre — University of Alberta, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.