Cost-effectiveness of direct oral anticoagulants versus vitamin K antagonist in atrial fibrillation: A study protocol using Real-World Data from Catalonia (FantasTIC Study). Issue 36 (4th September 2020)

• Record Type: Journal Article
• Authors: Hernández Rojas, Zojaina; Dalmau Llorca, Maria Rosa; Aguilar Martín, Carina; Gonçalves, Alessandra Queiroga; Casajuana, Marc; Fernández-Sáez, José; Rodríguez Cumplido, Dolores; Forcadell Drago, Emma; Carrasco-Querol, Noèlia; Pepió Vilaubí, Josep Maria; Alegret, Josep M.
• Other Names: Roever. Leonardo section editor.
• Is Part Of: Medicine. Volume 99:Issue 36(2020)
• Publication Date: 2020-09-04
• Subjects: atrial fibrillation -- cost effectiveness -- primary health care -- anticoagulants -- oral drug administration; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000022054
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: 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.