Cost-effectiveness of anticoagulation in patients with nonvalvular atrial fibrillation with edoxaban compared to warfarin in Germany

We compared the cost-utility analysis for edoxaban at both doses with that of dabigatran at both doses, rivaroxaban, and apixaban (non vitamin K antagonist oral anticoagulants, NOAC) in a German population. Data of clinical outcome events were taken from edoxaban’s ENGAGE-AF, dabigatran’s RE-LY, riv...

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Hauptverfasser: Krejczy, Martin (VerfasserIn) , Harenberg, Job (VerfasserIn) , Wehling, Martin (VerfasserIn) , Obermann, Konrad (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2015
In: BioMed research international

ISSN:2314-6141
DOI:10.1155/2015/876923
Online-Zugang:Verlag, kostenfrei, Volltext: http://dx.doi.org/10.1155/2015/876923
Verlag, kostenfrei, Volltext: https://www.hindawi.com/journals/bmri/2015/876923/abs/
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Verfasserangaben:Martin Krejczy, Job Harenberg, Martin Wehling, Konrad Obermann, Gregory Y.H. Lip
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Zusammenfassung:We compared the cost-utility analysis for edoxaban at both doses with that of dabigatran at both doses, rivaroxaban, and apixaban (non vitamin K antagonist oral anticoagulants, NOAC) in a German population. Data of clinical outcome events were taken from edoxaban’s ENGAGE-AF, dabigatran’s RE-LY, rivaroxaban’s ROCKET, and apixaban’s ARISTOTLE trials. The base-case analyses of a 65-year-old person with a CHADS2 score >1 gained 0.17 and 0.21 quality-adjusted life years over warfarin for 30 mg od and 60 mg od edoxaban, respectively. The incremental cost-effectiveness ratio was 50.000 and 68.000 euro per quality-adjusted life years for the higher and lower dose of edoxaban (Monte Carlo simulation). These findings were also similar to those for apixaban and more cost-effective than the other NOAC regimens. The current market costs for direct oral anticoagulants are high in relation to the quality of life gained from a German public health care insurance perspective. The willingness-to-pay threshold was lowest for 60 mg edoxaban compared to all direct oral anticoagulants and for 30 mg edoxaban compared to dabigatran and rivaroxaban.
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ISSN:2314-6141
DOI:10.1155/2015/876923