RT Journal Article
T1 [Cost-effectiveness analysis of apixaban versus acetylsalicylic acid in the prevention of stroke in patients with non-valvular atrial fibrillation in Spain].
T2 Análisis coste-utilidad de apixabán frente al ácido acetilsalicílico en la prevención del ictus en pacientes con fibrilación auricular no valvular en España.
A1 Escolar-Albaladejo, Ginés
A1 Barón-Esquivias, Gonzalo
A1 Zamorano, José Luis
A1 Betegón-Nicolás, Lourdes
A1 Canal-Fontcuberta, Cristina
A1 de Salas-Cansado, Marina
A1 Rubio-Rodríguez, Darío
A1 Rubio-Terrés, Carlos
K1 Acetylsalicylic acid
K1 Apixaban
K1 Apixabán
K1 Cost-effectiveness
K1 Coste-utilidad
K1 Fibrilación auricular no valvular
K1 Non-valvular atrial fibrillation
K1 Ácido acetilsalicílico
AB To assess the cost-effectiveness of apixaban versus acetylsalicylic acid (ASA) in stroke prevention in patients with non-valvular atrial fibrillation (NVAF) with contraindications of vitamin K antagonists in Spain. A Markov model was adapted, simulating the patient's lifetime. The safety and efficacy of the drugs were obtained from AVERROES clinical trial. The analysis was done from the Spanish National Health System (NHS) and societal perspective. The cost of drugs was calculated according to the recommended doses. The cost of NVAF complications and disease management was obtained from Spanish sources. In a cohort of 1,000 patients with NVAF, during their lifetime numerous complications could be avoided with apixaban versus ASA (48 ischemic strokes, 10 systemic embolism and 53 related deaths). In each patient treated with apixaban more life-years (0.303 LYG) and more quality-adjusted life-years (0.277 QALYs) could be gained. Apixaban would generate more costs per patient for the NHS (€1,742 per patient) but savings would result from the social perspective (€2,887 saved per patient). The cost per LYG and QALY gained would be of €5,749 and €6,289 for the NHS. Apixaban would be dominant (more effective with less costs than ASA) from the societal perspective. The results were stable in both deterministic and probabilistic sensitivity analyses. According to this model, when costs and estimated lifetime outcomes achieved with apixaban are compared with those of ASA, apixaban was assessed to be a cost-effective treatment for the prevention of stroke in patients with NVAF in Spain.
YR 2016
FD 2016-01-30
LK http://hdl.handle.net/10668/9797
UL http://hdl.handle.net/10668/9797
LA es
DS RISalud
RD Apr 6, 2025