Open AccessCost-effectiveness of direct oral anticoagulants versus vitamin K antagonist in atrial fibrillation
Author(s) -
Zojaina Hernández Rojas,
Maria Rosa Dalmau Llorca,
Carina Aguilar Martín,
Alessandra Queiroga Gonçalves,
Marc Casajuana,
José Fernández-Sáez,
Dolores Rodríguez Cumplido,
Emma Forcadell Drago,
Noèlia Carrasco-Querol,
Josep María Pepió Vilaubí,
Josep M. Alegret
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000022054
Subject(s) - medicine , atrial fibrillation , stroke (engine) , pharmacy , vitamin k antagonist , indirect costs , warfarin , population , vitamin k , intensive care medicine , emergency medicine , environmental health , family medicine , engineering , business , mechanical engineering , accounting
Background: Anticoagulant therapy is used for stroke prevention and proved to be effective and safe in the long term. The study aims to analyse the cost-effectiveness relationship of using of direct-acting oral anticoagulants vs vitamin K antagonists to prevent ischaemic stroke in patients with nonvalvular atrial fibrillation, including all the active ingredients marketed in Spain, prescribed for 2 years in the Primary Care service of the Institut Català de la Salut . Methods: Population-based cohort study, in which the cost of the 2 treatment groups will be evaluated. Direct costs (pharmacy, primary care, emergency and hospitalization) and indirect costs (lost productivity) will be included from a social perspective. Effectiveness (assessed as the occurrence of a health event, the 1 of primary interest being stroke) will be determined, with a 2-year time horizon and a 3% discount rate. The average cost of the 2 groups of drugs will be compared using a regression model to determine the factors with the greatest influence on determining costs. We will carry out a univariate (‘one-way’) deterministic sensitivity analysis. Discussion: We hope to provide relevant information about direct and indirect costs of oral anticoagulants, which, together with aspects of effectiveness and safety, could help shape the consensual decision-making of evaluating bodies.