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Giorgi, Mariano Anibal
Caroli, Christian
Giglio, Norberto Damian
Micone, Paula
Aiello, Eleonora
Vulcano, Cristina
Blanco, Julia
Donato, Bonnie
Quevedo, Joaquin Mould
Year of Publication: 
[Journal:] Health Economics Review [ISSN:] 2191-1991 [Volume:] 5 [Year:] 2015 [Issue:] 17 [Pages:] 1-10
Apixaban, a novel oral anticoagulant which has been approved for the prevention of stroke and systemic embolism in non-valvular atrial fibrillation, reduces both ischemic and haemorrhagic stroke and produces fewer bleedings than vitamin K antagonist warfarin. These clinical results lead to a decrease in health care resource utilization and, therefore, have a positive impact on health economics of atrial fibrillation. The cost-effectiveness of apixaban has been assessed in a variety of clinical settings and countries. However, data from emergent markets, as is the case of Argentina, are still scarce. We performed a cost-effectiveness analysis of apixaban versus warfarin in non-valvular atrial fibrillation (NVAF) in patients suitable for oral anticoagulation in Argentina. A Markov-based model including both costs and effects were used to simulate a cohort of patients with NVAF. Local epidemiological, resource utilization and cost data were used and all inputs were validated by a Delphi Panel of local experts. We adopted the payer's perspective with costs expressed in 2012 US Dollars. The study revealed that apixaban is cost-effective compared with warfarin using a willingness to pay threshold ranging from 1 to 3 per capita Gross Domestic Product (11558 - 34664 USD) with an incremental cost-effectiveness ratio of 786.08 USD per QALY gained. The benefit is primarily a result of the reduction in stroke and bleeding events. The study demonstrates that apixaban is a cost-effective alternative to warfarin in Argentina.
Novel oral anticoagulants
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