Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2017 Dec;17(6):481-492.
doi: 10.1007/s40256-017-0244-1.

All-Cause, Stroke-, and Bleed-Specific Healthcare Costs: Comparison among Patients with Non-Valvular Atrial Fibrillation (NVAF) Newly Treated with Dabigatran or Warfarin

Adrienne M Gilligan  1 , Pranav Gandhi  2 , Xue Song  3 , Cheng Wang  2 , Caroline Henriques  3 , Stephen Sander  2 , David M Smith  3
Affiliations
Comparative Study

All-Cause, Stroke-, and Bleed-Specific Healthcare Costs: Comparison among Patients with Non-Valvular Atrial Fibrillation (NVAF) Newly Treated with Dabigatran or Warfarin

Adrienne M Gilligan et al. Am J Cardiovasc Drugs. 2017 Dec.

Abstract

Objective: Our objective was to compare all-cause and stroke- and bleed-specific healthcare costs among patients with non-valvular atrial fibrillation (NVAF) treated with dabigatran or warfarin.

Methods: Administrative claims data from the MarketScan® Databases for 2009-2014 were used. Patients with NVAF newly treated with dabigatran were matched 1:1 to those treated with warfarin. All-cause and stroke- and bleed-specific costs per patient per month (PPPM) ($US, year 2015 values) up to a 12-month follow-up period were analyzed. Stroke- or bleed-specific costs were defined as hospitalizations with stroke or bleed as the primary discharge diagnosis and outpatient claims with stroke or bleed diagnosis in any position. Differences in costs between dabigatran and warfarin users were assessed using descriptive and multivariate analyses.

Results: A total of 18,980 dabigatran-treated patients were matched to corresponding warfarin-treated patients. Adjusted all-cause total healthcare, inpatient, and outpatient costs were significantly lower for the dabigatran cohort ($US3053 vs. 3433; $US904 vs. 1194; $US1594 vs. 1894, respectively; all p < 0.001), but mean pharmacy costs were significantly higher ($US556 vs. 345, p < 0.001). Stroke-specific total healthcare and outpatient costs were significantly lower for the dabigatran than for the warfarin cohort ($US30.37 vs. 40.99 and $US7.36 vs. 12.20, respectively; p < 0.05 for both values). Similarly, bleed-specific total healthcare and inpatient costs were significantly lower for the dabigatran than for the warfarin cohort ($US50.00 vs. 73.49 and $US27.75 vs. 48.66, respectively; p < 0.01 for both values).

Conclusion: Patients receiving dabigatran had significantly lower total all-cause, inpatient, and outpatient costs but higher pharmacy costs than those receiving warfarin. In addition, stroke-specific total and outpatient costs and bleed-specific total and inpatient costs were significantly lower in dabigatran users compared with warfarin users.

PubMed Disclaimer

Conflict of interest statement

Funding

This study was funded by Boehringer-Ingelheim Pharmaceuticals Inc. and conducted by Truven Health Analytics, USA.

Conflict of interest

All listed authors meet the criteria for authorship set forth by the International Committee for Medical Journal Editors. Adrienne Gilligan, Xue Song, Caroline Henriques, and David Smith are employees of Truven Health Analytics, which received compensation from Boehringer-Ingelheim Pharmaceuticals Inc. for the overall conduct of the study and preparation of this manuscript. Pranav Gandhi, Cheng Wang, and Stephen Sander are employees of Boehringer-Ingelheim Pharmaceuticals Inc.

References

    1. Centers for Disease Control and Prevention. Division for Heart Disease and Stroke Prevention. Atrial fibrillation fact sheet. Atlanta, GA: U.S. Department of Health & Human Services; 2015. https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_atrial_fibrilla.... Accessed 12 Sept 2016.
    1. Dasta JF, Pilon D, Mody SH, Lopatto J, Laliberté F, Germain G, et al. Daily costs of hospitalization in non-valvular atrial fibrillation patients treated with anticoagulant therapy. J Med Econ. 2015;18(12):1041–1049. doi: 10.3111/13696998.2015.1074583. - DOI - PubMed
    1. Shea JB, Sears SF. A patient’s guide to living with atrial fibrillation. Circulation. 2008;117(20):e340–e343. doi: 10.1161/CIRCULATIONAHA.108.780577. - DOI - PubMed
    1. Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA. 2001;285(18):2370–2375. doi: 10.1001/jama.285.18.2370. - DOI - PubMed
    1. Wolf PA, D’Agostino RB, Belanger AJ, Kannel WB. Probability of stroke: a risk profile from the Framingham Study. Stroke. 1991;22(3):312–318. doi: 10.1161/01.STR.22.3.312. - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources