PHARMACOECONOMIC ASPECTS OF APIXABAN FOR PREVENTION OF THROMBOEMBOLIC EVENTS IN PATIENTS WITH ATRIAL FIBRILLATION
https://doi.org/10.20996/1819-6446-2015-11-1-60-62
Abstract
For prevention of thromboembolic events in patients with non-valvular atrial fibrillation (NVAF) the following types of antithrombotic therapy are used: anticoagulant therapy with vitamin K antagonists (warfarin), antiplatelet therapy (acetylsalicylic acid) and novel oral anticoagulants such as apixaban, rivaroxaban and dabigatran. Along with clinical efficacy and safety profile one of the main characteristics of any medical technology is economic value and cost-effectiveness. The objective of this review was to describe pharmacoeconomic aspects of using apixaban for stroke and other cardiovascular events prevention in patients with NVAF. Results of the previously published cost-effectiveness studies demonstrated that apixaban was projected to increase life expectancy of the patients with NVAF compared with standards of care warfarin and aspirin, novel oral anticoagulants rivaroxaban and dabigatran. At the same time apixaban is expected to be cost-effective alternative from the Russian Federation national healthcare budget perspective.
About the Author
A. V. Rudakova
Saint-Petersburg State Chemical Pharmaceutical Academy
Russian Federation
Professora Popova ul. 14, Saint-Petersburg, 197376 Russia
Russian Federation
Professora Popova ul. 14, Saint-Petersburg, 197376 Russia
References
1. Hart R.G., Pearce L.A., Aguilar M.I. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med 2007;146 (12): 857-67.
2. Jones M., McEwan P., Morgan L-l.C., et al. Evaluation of the pattern of treatment, level of anticoagulation control, and outcome of treatment with warfarin in patients with non-valvar atrial fibrillation: a record linkage study in a large British population. Heart 2005; 91: 472-77.
3. Hylek E.M., Skates S.J., Sheehan M.A., Singer D.E. An analysis of the lowest effective intensity of prophylactic anticoagulation for patients with nonrheumatic atrial fibrillation. N Engl J Med 1996; 335(8): 540-6.
4. Diagnosis and treatment of atrial fibrillation. Recommendations RCS, RSSA, RACVS (2012). Available at: http://scardio.ru/content/Guidelines/FP_rkj_13.pdf. Accessed by 19/02/2015. Russian (Диагностика и лечение фибрилляции предсердий. Рекомендации РКО, ВНОА и АССХ (2012). Доступно на: http://scardio.ru/content/Guidelines/FP_rkj_13.pdf. Проверено 19.02.2015).
5. Hart R. G., Pearce, L. A., Koudstaal, P. J. Transient Ischemic Attacks in Patients With Atrial Fibrillation: Implications for Secondary Prevention: The European Atrial Fibrillation Trial and Stroke Prevention in Atrial Fibrillation III Trial. Stroke 2004; 35: 948-51.
6. Belousov YB, Yavelov IS, Belousov DYu, Afanasyeva EV. Direct costs associated with the use of warfarin in patients with atrial fibrillation. Ration Pharmacother Cardiol 2011; (5): 561-6. Russian (Белоусов Ю.Б., Явелов И.С., Белоусов Д.Ю, Афанасьева Е.В. Прямые затраты ассоциированные с применением варфарина у пациентов с фибрилляцией предсердий. Рациональная Фармакотерапия в Кардиологии 2011; 5: 561-6).
7. Meschia J., Bushnell C., Boden-Albala B., et al. Guidelines for the Primary Prevention of Stroke A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 2014; 45: 3754-832.
8. Kernan W., Ovbiagele B., Black H., et al. Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack. Stroke 2014; 45: 2160-236.
9. Granger C.B., Alexander J.H., McMurray J.J., et al. Apixaban vs. warfarin in patients with atrial fibrillation. N Engl J Med 2011; 365: 981-92.
10. Connolly S.J., Ezekowitz M.D., Yusuf S., et al. Dabigatran vs. warfarin in patients with atrial fibrillation. N Engl J Med 2009; 361: 1139-51.
11. Patel M.R., Mahaffey K.W., Garg J., et al. Rivaroxaban vs. warfarin in nonvalvular atrial fibrillation. N Engl J Med 2011; 365: 883-91.
12. Connolly S.J., Eikeboom J., Joyner C., et al. Apixaban in patients with atrial fibrillation. N Engl J Med 2011; 364: 806-17.
13. Camm A.J., Lip G., De Caterina R., et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation. An update of the 2010 ESC Guidelines for the management of atrial fibrillation developed with the special contribution of the European Heart Rhythm Association. Eur Heart J 2012; 33: 2719-247.
14. Rudakova AV, Tatarskii BA. Pharmacoeconomic aspects of apixaban and other new oral anticoagulants in patients with non-valvular atrial fibrillation. Kardiologiia 2014; 54 (7): 43-52. Russian (Рудакова А.В., Татарский Б.А. Фармакоэкономические аспекты применения апиксабана и других новых пероральных антикоагулянтов у пациентов с неклапанной фибрилляцией предсердий. Кардиология 2014; 54(7): 43-52).
15. Rudakova AV, Parfenov VA. Pharmacoeconomic aspects of prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation: Take-tion apixaban compared with warfarin and aspirin. Ration Pharmacother Cardiology 2014; 10 (3): 275-82. Russian (Рудакова А.В., Парфенов В.А. Фармакоэкономические аспекты профилактики инсульта и системной тромбоэмболии у пациентов с неклапанной фибрилляцией предсердий: применение апиксабана по сравнению с варфарином и ацетилсалициловой кислотой. Рациональная Фармакотерапия в Кардиологии 2014; 10(3): 275-82).
16. World Health Organization. Investing in Health for Economic Development. Report of the Commission on Macroeconomics and Health. Geneva (Switzerland): World Health Organization; 2001.
Review
For citations:
Rudakova A.V. PHARMACOECONOMIC ASPECTS OF APIXABAN FOR PREVENTION OF THROMBOEMBOLIC EVENTS IN PATIENTS WITH ATRIAL FIBRILLATION. Rational Pharmacotherapy in Cardiology. 2015;11(1):60-62. (In Russ.) https://doi.org/10.20996/1819-6446-2015-11-1-60-62
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