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Observational Study
. 2023 Aug;12(8):e230007.
doi: 10.57264/cer-2023-0007. Epub 2023 Jul 25.

Healthcare resources and costs associated with nonvalvular atrial fibrillation in Spain: apixaban versus acenocoumarol

Josep Comín Colet  1 , Antoni Sicras Mainar  2 , Joel Salazar-Mendiguchía  3 , María Isabel Del Campo Alonso  3 , Ainara Echeto  3 , David Vilanova Larena  3 , Olga Delgado Sánchez  4
Affiliations
Observational Study

Healthcare resources and costs associated with nonvalvular atrial fibrillation in Spain: apixaban versus acenocoumarol

Josep Comín Colet et al. J Comp Eff Res. 2023 Aug.

Abstract

Aim: Healthcare resources usage and costs associated to nonvalvular atrial fibrillation (NVAF) were analyzed in Spain. Methods: This is an observational and retrospective study on patients with NVAF who started their treatment with apixaban or acenocoumarol between 1 January 2015 and 31 December 2017. Results: 2160 patients treated with apixaban were paired (1:1) with patients treated with acenocoumarol (propensity score matching). Apixaban reduced the incidence of strokes and systemic embolisms, minor and major bleedings and deaths, versus acenocoumarol. Apixaban led to reductions of 80, 55 and 43% in costs related to nursing visits, hospitalizations, and emergency visits, respectively, leading to annual cost savings of €274/patient, from the perspective of society. Conclusion: Our results suggested that apixaban is a cost-effective alternative for patients with NVAF.

Keywords: acenocoumarol; apixaban; cardiovascular events; cost–effectiveness; healthcare resources.

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Conflict of interest statement

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Figures

Figure 1.
Figure 1.. Clinical events per study group after propensity score matching.
Results expressed as percentage of equivalent events per 100-person-year (n for each study group = 2160). *Stroke and systemic embolism: n = 124 (44 vs 80); HR = 0.54 (95% CI: 0.38–0.78; p = 0.001, **Minor bleeding: n = 392 (156 vs 236); HR = 0.64 (95% CI: 0.52–0.79); p < 0.001; ***Major bleeding: n = 152 (52 vs 100); HR = 0,51 (95% CI: 0.37–0.72); p < 0.001. DOAC: Direct-acting oral anticoagulant; HR: Hazard ratio; p: Statistical significance. Figure created using data from Ramagopalan et al. [17]
Figure 2.
Figure 2.. Patient flow diagram.
Figure 3.
Figure 3.. Cost per patient year by type of cost.
Figure 4.
Figure 4.. Corrected cost per study group.
See this image and copyright information in PMC

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