Cost‐Effectiveness of Dabigatran Compared With Warfarin for Stroke Prevention in Patients With Atrial Fibrillation—A Real Patient Data Analysis in a Hong Kong Teaching Hospital. Issue 5 (14th March 2013)

• Record Type: Journal Article
• Authors: Chang, Andy M.; Ho, Jason C. S.; Yan, Bryan P.; Yu, Cheuk Man; Lam, Yat Yin; Lee, Vivian W. Y.
• Is Part Of: Clinical cardiology. Volume 36:Issue 5(2013:May)
• Page Start: 280
• Page End: 285
• Publication Date: 2013-03-14
• Subjects: Cardiology -- Periodicals; 616.12005
• DOI: 10.1002/clc.22112
• Languages: English
• ISSNs: 0160-9289

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="clc22112-sec-0001" sec-type="section"> <title>Background</title> <p>To compare the management cost and cost‐effectiveness of dabigatran with warfarin in patients with nonvalvular atrial fibrillation (AF) from the hospital's and patients' perspectives.</p> </sec> <sec id="clc22112-sec-0002" sec-type="section"> <title>Hypothesis</title> <p>Dabigatran is more cost‐effective than warfarin for stroke prevention of AF in Hong Kong.</p> </sec> <sec id="clc22112-sec-0003" sec-type="section"> <title>Methods</title> <p>The analysis was performed in conjunction with a drug utilization evaluation of dabigatran study in a teaching hospital in Hong Kong. The study recruited 244 patients who received either dabigatran or warfarin for stroke prevention of AF. A cost‐effectiveness analysis was performed and was expressed as an incremental cost‐effectiveness ratio (ICER) in averting a cardiac event or a bleeding event. A sensitivity analysis was used on all relevant variables to test the robustness.</p> </sec> <sec id="clc22112-sec-0004" sec-type="section"> <title>Results</title> <p>From the hospital's perspective, the dabigatran group had a lower total cost of management than that of the warfarin group (median: US$421 vs US$1306, <italic>P</italic> < 0.001) (US$1 = HK$7.75) and was dominant over warfarin. From the patients' perspective, the total cost of management in the dabigatran group was higher than that in warfarin group (median: US$1751 vs US$70, <italic>P</italic> < 0.001), and the ICER in preventing a cardiac or bleeding event of dabigatran vs warfarin was estimated at US$68 333 and US$20 500, respectively. If dabigatran was subsidized by the hospital, a higher cost would be incurred by the hospital (median: US$1679 vs US$1306, ICER (cardiac and bleeding events): US$15 163 and US$4549, respectively).</p> </sec> <sec id="clc22112-sec-0005" sec-type="section"> <title>Conclusions</title> <p>The study favored dabigatran for stroke prophylaxis in patients with nonvalvular AF in Hong Kong under the current hospital's perspective and provided a reference for further comparisons under patient and subsidization perspectives.</p> </sec> </abstract>