Cost Effectiveness of Oral Anticoagulation Therapy for Non-Valvular Atrial Fibrillation Patients: Warfarin Versus the New Oral Anticoagulants Rivaroxaban, Dabigatran and Apixaban

Ortiz-Cartagena, Ismael; Gotay, Antonio Orraca; Acevedo, Jose

doi:10.1016/s0735-1097(18)31031-3

Cited by 6 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 22 However, what is novel in the current study was the wide variety of the bleeding sites and the wide range of anticoagulation therapeutic agents used for various reasons, such as VTE prophylaxis or treatment, in correlation with coagulation profile and kidney and liver function and management and or interventions that were conducted at the time of presentation. Although it might be argued that upfront costs for warfarin administration are cheaper when compared with DOACs, 10 our finding suggests that DOACs are more cost-effective overall in the long run when compared with warfarin or other agents, considering the reduced likelihood of patients’ presentations to ED and receiving reversal and the significantly shorter LoS.…”

Section: Discussionmentioning

confidence: 64%

“… 6 – 8 While more specific, 9 the DOACs are more costly than warfarin, which may hinder widespread use in the community, even though they do not need a specific monitoring test. 10 Balancing the benefits of anticoagulants against the associated risks is a concern for clinical practice and requires further real-world evidence to support decision-making.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Real world data on characteristics and management of community patients receiving anticoagulation therapy who presented with acute bleeding to the emergency department at a regional Australian hospital: A prospective observational study.

Hanna

Hyppa

Prakash³

et al. 2021

Mediterr J Hematol Infect Dis

View full text Add to dashboard Cite

Objective: To study patients receiving anticoagulants with or without antiplatelet therapy presenting at a regional Australian hospital with bleeding. The main aims are to explore: (1) patients’ characteristics and management provided; (2) association between the type of anticoagulant and antiplatelet agent used and the requirement of reversal; (3) and the length of hospital stay (LoS) in conjunction with bleeding episode and management. Methods: A prospective cross-sectional review of medical records of all patients who presented at a tertiary referral centre with bleeding while receiving anticoagulation therapy between January 2016 and June 2018. Data included: demographics, investigations (kidney and liver function tests, coagulation profile, FBC), LoS, bleeding site, type of and reason for anticoagulation therapy, and management provided. Data analysis included descriptive statistics, ?2 association, and regression models. Results: Among the 144 eligible patients, 75 (52.1%) were male, and the mean age was 76 years (SD=11.1). Gastrointestinal tract bleeding was the most common (n=48, 33.3%), followed by epistaxis (n=32, 22.2%). Atrial fibrillation was the commonest reason for anticoagulation therapy (n=65, 45.1%). Warfarin was commonly used (n=74, 51.4%), followed by aspirin (n=29, 20.1%), rivaroxaban (n=26, 18.1%), and apixaban (n=12, 8.3%). A majority had increased blood urea nitrogen (n=67, 46.5%), while 58 (40.3%) had an elevated serum creatinine level, and 59 (41.0%) had a mild reduction in eGFR. Thirty-five of the warfarinised patients (47.3%) had an INR above the target range of their condition despite normal liver function. Severe anaemia (Hb<80g/L) was reported in 88 patients (61.1%). DOACs were associated with a reduced likelihood of receiving reversal (B= -1.7, P=<.001), and with a shorter LoS (B= -4.1, P=.046) when compared with warfarin, LMWH, and antiplatelet therapy. Conclusion: Warfarin use was common among patients who presented with acute bleeding, and the INR in many warfarinised patients exceeded the target for their condition. DOACs were associated with a reduced likelihood for receiving reversal and with a shorter LoS when compared to warfarin, LMWH, which might support wider application of DOACs into community practice.

show abstract

Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Real world data on characteristics and management of community patients receiving anticoagulation therapy who presented with acute bleeding to the emergency department at a regional Australian hospital: A prospective observational study.

Hanna

Hyppa

Prakash³

et al. 2021

Mediterr J Hematol Infect Dis

View full text Add to dashboard Cite

show abstract

“…However in real terms the total cost of inpatient admissions, in the Warfarin group is higher than the DOAC's, leading to considering DOAC's as a cost-effective alternative to Warfarin in this scenario. [ 79 ]…”

Section: Eterminants Of C Hoice Of mentioning

confidence: 99%

Moving towards ideal and appropriate models of anticoagulation management service

Raphael

2020

Ann Afr Med

View full text Add to dashboard Cite

Accuracy of symptoms and pulse checking for detecting atrial fibrillation following catheter ablation

Markman,

Peters,

Tate

et al. 2023

J Interv Card Electrophysiol

View full text Add to dashboard Cite

Cost Effectiveness of Oral Anticoagulation Therapy for Non-Valvular Atrial Fibrillation Patients: Warfarin Versus the New Oral Anticoagulants Rivaroxaban, Dabigatran and Apixaban

Cited by 6 publications

References 0 publications

Real world data on characteristics and management of community patients receiving anticoagulation therapy who presented with acute bleeding to the emergency department at a regional Australian hospital: A prospective observational study.

Real world data on characteristics and management of community patients receiving anticoagulation therapy who presented with acute bleeding to the emergency department at a regional Australian hospital: A prospective observational study.

Moving towards ideal and appropriate models of anticoagulation management service

Accuracy of symptoms and pulse checking for detecting atrial fibrillation following catheter ablation

Contact Info

Product

Resources

About