Edward P. Armstrong

Cost-Effectiveness of Apixaban, Dabigatran, Rivaroxaban, and Warfarin for Stroke Prevention in Atrial Fibrillation

Background and Purpose— To estimate the cost-effectiveness of stroke prevention in patients with nonvalvular atrial fibrillation by using novel oral anticoagulants apixaban 5 mg, dabigatran 150 mg, and rivaroxaban 20 mg compared with warfarin. Methods— A Markov decision-analysis model was constructed using data from clinical trials to evaluate lifetime costs and quality-adjusted life-years of novel oral anticoagulants compared with warfarin. The modeled population was a hypothetical cohort of 70-year-old patients with nonvalvular atrial fibrillation, increased risk for stroke (CHADS2 ≥1), renal creatinine clearance ≥50 mL/min, and no previous contraindications to anticoagulation. The willingness-to-pay threshold was

Clinical and Economic Analysis of Methicillin-Susceptible and -Resistant Staphylococcus aureus Infections

50 000/quality-adjusted life-years gained. Results— In the base case, warfarin had the lowest cost of

Acute Exacerbations of COPD in the United States: Inpatient Burden and Predictors of Costs and Mortality

77 813 (SD,

Impact of Postherpetic Neuralgia and Painful Diabetic Peripheral Neuropathy on Health Care Costs

2223), followed by rivaroxaban 20 mg (

Pharmacist workload and pharmacy characteristics associated with the dispensing of potentially clinically important drug-drug interactions

78 738±

Prescribers' knowledge of and sources of information for potential drug-drug interactions: a postal survey of US prescribers.

1852), dabigatran 150 mg (

Pharmacoeconomic Evaluation of Antimuscarinic Agents for the Treatment of Overactive Bladder

82 719±

The impact of nonsteroidal anti-inflammatory drugs on blood pressure, with an emphasis on newer agents.

1959), and apixaban 5 mg (

Escitalopram versus sertraline in the treatment of major depressive disorder: a randomized clinical trial*

85 326±

Performance of Drug-Drug Interaction Software for Personal Digital Assistants

1512). Apixaban 5 mg had the highest quality-adjusted life-years estimate at 8.47 (SD, 0.06), followed by dabigatran 150 mg (8.41±0.07), rivaroxaban 20 mg (8.26±0.06), and warfarin (7.97±0.04). In a Monte Carlo probabilistic sensitivity analysis, apixaban 5 mg, dabigatran 150 mg, rivaroxaban 20 mg, and warfarin were cost-effective in 45.1%, 40%, 14.9%, 0% of the simulations, respectively. Conclusions— In patients with nonvalvular atrial fibrillation and an increased risk of stroke prophylaxis, apixaban 5 mg, dabigatran 150 mg, and rivaroxaban 20 mg were all cost-effective alternatives to warfarin. The cost-effectiveness of novel oral anticoagulantss was dependent on therapy pricing in the United States and neurological events associated with rivaroxaban 20 mg.