Payer and Physicians Evidence and Discount Expectations for Biosimilars in Six Latin American Countries

Abstract

A667 ate the efficacy and safety of new anticoagulants in the treatment of AF. Methods: Health Technology Assessment of multiple technologies. We searched the electronic databases Cochrane Library, CRD, Pubmed, Embase and Lilacs, to search for the best available evidence assessing the new oral anticoagulants, compared with warfarin in patients with AF. Results: Three randomized controlled trials evaluating dabigatran (110mg e 150mg), rivaroxaban 20mg and apixaban 5mg were included, all of them compared with warfarin. In this regard, dabigatran 110mg was associated with similar rates of stroke or systemic embolism and with a 20% relative risk reduction (RRR) of major hemorrhage compared with warfarin. Dabigatran 150mg was associated with a 34% RRR of stroke or systemic embolism and similar rates of major hemorrhage. Rivaroxaban 20mg was associated with similar rates of the primary efficacy and safety outcomes. Finally, apixaban was associated with a 21% RRR of stroke or systemic embolism and with 31% RRR of major bleeding compared with warfarin. ConClusions: There is strong evidence supporting these new technologies, especially regarding safety. Further studies are needed to support decision making, especially with regards to cost-effectiveness issues.