Cost-effectiveness of anticoagulation in patients with nonvalvular atrial fibrillation with edoxaban compared to warfarin in Germany

• Verfasst von: Krejczy, Martin [VerfasserIn]
• Verfasst von: Harenberg, Job [VerfasserIn]
• Verfasst von: Wehling, Martin [VerfasserIn]
• Verfasst von: Obermann, Konrad [VerfasserIn]
• Titel: Cost-effectiveness of anticoagulation in patients with nonvalvular atrial fibrillation with edoxaban compared to warfarin in Germany
• Verf.angabe: Martin Krejczy, Job Harenberg, Martin Wehling, Konrad Obermann, Gregory Y.H. Lip
• Jahr: 2015
• Umfang: 13 S.
• Fussnoten: Gesehen am 30.05.2017
• Titel Quelle: Enthalten in: BioMed research international
• Ort Quelle: New York [u.a.] : Hindawi, 2013
• Jahr Quelle: 2015
• Band/Heft Quelle: (2015) Article ID e876923, 13 Seiten
• ISSN Quelle: 2314-6141
• DOI: doi:10.1155/2015/876923
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1559128267

Abstract

We compared the cost-utility analysis for edoxaban at both doses with that of dabigatran at both doses, rivaroxaban, and apixaban (non vitamin K antagonist oral anticoagulants, NOAC) in a German population. Data of clinical outcome events were taken from edoxaban’s ENGAGE-AF, dabigatran’s RE-LY, rivaroxaban’s ROCKET, and apixaban’s ARISTOTLE trials. The base-case analyses of a 65-year-old person with a CHADS2 score >1 gained 0.17 and 0.21 quality-adjusted life years over warfarin for 30 mg od and 60 mg od edoxaban, respectively. The incremental cost-effectiveness ratio was 50.000 and 68.000 euro per quality-adjusted life years for the higher and lower dose of edoxaban (Monte Carlo simulation). These findings were also similar to those for apixaban and more cost-effective than the other NOAC regimens. The current market costs for direct oral anticoagulants are high in relation to the quality of life gained from a German public health care insurance perspective. The willingness-to-pay threshold was lowest for 60 mg edoxaban compared to all direct oral anticoagulants and for 30 mg edoxaban compared to dabigatran and rivaroxaban.