Volumen: 17 # Number : 2
Publication Date : Mayo - Agosto Year: 2013
Authors: Ferrante, D.
Abstract: Objectives: Dabigatran has shown to be effective in preventing embolic events in chronic atrial fibrillation patients. The objective of this study is to estimate the cost-utility of dabigatran used in recommended doses for the prevention of thromboembolic events in chronic atrial fibrillation. Methods: A Markov model was constructed
to simulate a cohort of patients aged 65 or more, with atrial fibrillation. The strategies compared were dabigatran (300 mg) or coumarins. Markov states were: no events, ischemic stroke, hemorrhagic stroke and death. Resource use was obtained from the National Admissions Database for stroke admissions and major
bleedings. Costs were obtained from national health providers, both for anticoagulation costs and admissions costs. Discount rate was 3%, cost and effects. The results were expressed in incremental cost-utility ratios (Argentinean pesos – ARS – per QUALY). Sensitivity
analysis variables: stroke risk, 95% CI of relative risks of RE-LY study, stroke cost. Results: In the base case analysis, dabigatran 300 mg shown to be more effective than cumarins (incremental QUALYs 0.49), with an incremental cost of ARS 5.923, resulting in an ICER of 12.040 ARS per QUALY gained. Dabigatran was associated
with higher drug costs, but lower events costs. In all one way sensitivity analysis, dabigatran remained as a cost-effective strategy. Conclusions: Dabigatran is a cost-effective strategy for anticoagulation in chronic atrial fibrillation patients in Argentina, even considering different population characteristics, resource use and costs of ower local setting.
Key words: Atrial fibrillation, stroke, dabigatran, cost-utility
Pages : 115-121
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