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Cost-effectiveness of dabigatran compared with warfarin for patients with atrial fibrillation in Sweden
Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.ORCID iD: 0000-0002-9375-5087
Uppsala University, Sweden .
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2013 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 34, no 3, 177-183 p.Article in journal (Refereed) Published
Abstract [en]

Patients with atrial fibrillation have a significantly increased risk of thromboembolic events such as ischaemic stroke, and patients are therefore recommended to be treated with anticoagulation treatment. The most commonly used anticoagulant consists of vitamin K antagonist such as warfarin. A new oral anticoagulation treatment, dabigatran, has recently been approved for stroke prevention among patients with atrial fibrillation. The purpose of this study was to estimate the cost-effectiveness of dabigatran as preventive treatment of stroke and thromboembolic events compared with warfarin in 65-year-old patients with atrial fibrillation in Sweden. less thanbrgreater than less thanbrgreater thanA decision analytic simulation model was used to estimate the long-term (20-year) costs and effects of the different treatments. The outcome measures are the number of strokes prevented, life years gained, and quality-adjusted life years (QALYs) gained. Costs and effect data are adjusted to a Swedish setting. Patients below 80 years of age are assumed to start with dabigatran 150 mg twice a day and switch to 110 mg twice a day at the age of 80 years due to higher bleeding risk. The price of dabigatran in Sweden is Euro2.82 (Swedish kronor 25.39) per day for both doses. The cost per QALY gained for dabigatran compared with warfarin is estimated at Euro7742, increasing to Euro12 449 if dabigatran is compared with only well-controlled warfarin treatment. less thanbrgreater than less thanbrgreater thanDabigatran is a cost-effective treatment in Sweden, as its incremental cost-effectiveness ratio is below the normally accepted willingness to pay limit.

Place, publisher, year, edition, pages
Oxford University Press (OUP): Policy B , 2013. Vol. 34, no 3, 177-183 p.
Keyword [en]
Cost-effectiveness, Atrial fibrillation, Anticoagulants, Stroke
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-89523DOI: 10.1093/eurheartj/ehs157ISI: 000313831000008OAI: oai:DiVA.org:liu-89523DiVA: diva2:608234
Note

Funding Agencies|Boehringer Ingelheim||County council of Ostergotland, Sweden||Bayer||Bristol-Myers Squibb||Pfizer||

Available from: 2013-02-26 Created: 2013-02-26 Last updated: 2017-12-06

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Davidson, ThomasHusberg, MagnusJanzon, MagnusLevin, Lars-Åke

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Health Technology Assessment and Health EconomicsFaculty of Health SciencesCardiologyDepartment of Cardiology UHL
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