Economic evaluation of rivaroxaban in stroke prevention for patients with atrial fibrillation in Greece
- PDF / 256,713 Bytes
- 10 Pages / 595.28 x 793.7 pts Page_size
- 3 Downloads / 230 Views
RESEARCH
Open Access
Economic evaluation of rivaroxaban in stroke prevention for patients with atrial fibrillation in Greece Georgia Kourlaba1*, Nikos Maniadakis2, George Andrikopoulos3 and Panos Vardas4
Abstract Background: To undertake an economic evaluation of rivaroxaban relative to the standard of care for stroke prevention in patients with non-valvular atrial fibrillation (AF) in Greece. Methods: An existing Markov model designed to reflect the natural progression of AF patients through different health states, in the course of three month cycles, was adapted to the Greek setting. The analysis was undertaken from a payer perspective. Baseline event rates and efficacy data were obtained from the ROCKET-AF trial for rivaroxaban and vitamin-K-antagonists (VKAs). Utility values for events were based on literature. A treatment-related disutility of 0.05 was applied to the VKA arm. Costs assigned to each health state reflect the year 2013. An incremental cost effectiveness ratio (ICER) was calculated where the outcome was quality-adjusted-life year (QALY) and life-years gained. Probabilistic analysis was undertaken to deal with uncertainty. The horizon of analysis was over patient life time and both cost and outcomes were discounted at 3.5%. Results: Based on safety-on-treatment data, rivaroxaban was associated with a 0.22 increment in QALYs compared to VKA. The average total lifetime cost of rivaroxaban-treated patients was €239 lower compared to VKA. Rivaroxaban was associated with additional drug acquisition cost (€4,033) and reduced monitoring cost (-€3,929). Therefore, rivaroxaban was a dominant alternative over VKA. Probabilistic analysis revealed that there is a 100% probability of rivaroxaban being cost-effective versus VKA at a willingness to pay threshold of €30,000/QALY gained. Conclusion: Rivaroxaban may represent for payers a dominant option for the prevention of thromboembolic events in moderate to high risk AF patients in Greece. Keywords: Cost-effectiveness, Vitamin-K-antagonists, Cost-utility
Background Atrial Fibrillation (AF) constitutes a significant public health problem as it is strongly associated with increased risk of morbidity, such as stroke, heart failure, left ventricular dysfunction and thromboembolism, increased risk of mortality and reduced quality of life (QoL) [1-3]. Stroke is the most devastating and feared complication of AF, and in the absence of anti-thrombotic therapy the
* Correspondence: [email protected] 1 The Stavros Niarchos Foundation-Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), Thivon & Papadiamantopoulou, Goudi, Athens 115 27, Greece Full list of author information is available at the end of the article
annual risk of stroke in patients with non-valvular AF increases from about 5% in patients less than 65 years of age to about 8% in patients 75 years of age or older [1]. Along with mortality and morbidity, AF imposes a great economic burden which stems from the excess health care resources utilization related to the management of t
Data Loading...
