Real-life cost of vitamin K antagonist treatment in patients with non-valvular atrial fibrillation in France in 2013. (2nd September 2017)

• Record Type: Journal Article
• Authors: Dallongeville, Jean; Ansolabehere, Xavier; Karusisi, Noëlla; Maurel, Frédérique; Van Ganse, Eric; Le Heuzey, Jean-Yves
• Is Part Of: Journal of medical economics. Volume 20:Number 9(2017)
• Page Start: 974
• Page End: 981
• Publication Date: 2017-09-02
• Subjects: Vitamin K antagonist -- Cost of treatment -- French claims data -- Real-life study -- Non-valvular atrial fibrillation; Medical care -- Cost control -- Periodicals; Medical economics -- Periodicals; 362.10941
• DOI: 10.1080/13696998.2017.1352508
• Languages: English
• ISSNs: 1369-6998

Abstract

Abstract: Aims: Data highlighting the cost drivers for non-valvular atrial fibrillation (NVAF) patients in terms of vitamin K antagonist (VKA) treatment and monitoring are lacking in France. This study aimed to evaluate the real-life daily cost of VKA treatment in 2013, in French patients suffering from NVAF. Methods: This longitudinal observational study was performed using the EGB (Echantillon Généraliste des Bénéficiaires) database, a random sample of the French national insurance (NHI) database, which covers 80% of the population. All adult patients whose first NVAF anticoagulant treatment in 2013 was a VKA were analyzed. Costs were calculated for the duration of follow-up and then divided by the number of days of therapy. The analysis was performed both from the French NHI perspective (amount reimbursed by the NHI) and from a collective perspective. Results: In this study, 3, 254 NVAF patients treated with VKA in 2013 were included, and this sample comprised 52.6% males. The mean daily cost of VKA treatment was €1.13 (±1.18) according to the collective perspective (89.4% of this cost was associated to INR measurement) and €1.05 (±1.16) according to the NHI perspective. Limitations: As diagnoses associated with procedures are not available in the EGB database, proxies were used, and an algorithm was created to define the AF population. Conclusions: This analysis is the first to consider an exhaustive spectrum of the costs of VKA treatment in France using EGB data. VKA medication requires exhaustive follow-up, and, thus, associated costs are important. The results of the present study confirmed this close follow-up for VKA patients, making the cost of treatment by VKA nearly 10-times more expensive than the cost of medication itself.