SynthesisPloS one2013
Novel anticoagulants for stroke prevention in atrial fibrillation: a systematic review of cost-effectiveness models.
Synthesis in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04357288 (Randomized Evaluation of Decision Support Interventions for Atrial Fibrillation), which is not on this map. Cited by 25 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Randomized Evaluation of Decision Support Interventions for Atrial Fibrillation
Who cites it
25 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Methods for Economic Evaluations of Novel Oral Anticoagulants in Patients with Atrial Fibrillation: A Systematic Review.Applied health economics and health policy · 2024Pooled it
- Cost Effectiveness of Strategies to Manage Atrial Fibrillation in Middle- and High-Income Countries: A Systematic Review.PharmacoEconomics · 2023Pooled it
- Economic evaluation of direct oral anticoagulants (DOACs) versus vitamin K antagonists (VKAs) for stroke prevention in patients with atrial fibrillation: a systematic review and meta-analysis.BMJ evidence-based medicine · 2022Pooled it
- Pooled it
- Economic Value of Pharmacogenetic Testing for Cancer Drugs with Clinically Relevant Drug-Gene Associations: A Systematic Literature Review.Journal of managed care & specialty pharmacy · 2019Pooled it
- Pooled it
- Cost-effectiveness analysis of anticoagulation options for non-valvular atrial fibrillation in Iran.BMC research notes · 2024Article
- Global access to affordable direct oral anticoagulants.Bulletin of the World Health Organization · 2021Article
- Computational modeling: What does it tell us about atrial fibrillation therapy?International journal of cardiology · 2019Review
- A Comparison of Oral Anticoagulant Use for Atrial Fibrillation in the Pre- and Post-DOAC Eras.Drugs & aging · 2016Observational
- Cost-effectiveness of edoxaban versus rivaroxaban for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF) in the US.ClinicoEconomics and outcomes research : CEOR · 2016Article
- Cost-effectiveness of apixaban vs. other new oral anticoagulants for the prevention of stroke: an analysis on patients with non-valvular atrial fibrillation in the Greek healthcare setting.Clinical drug investigation · 2015Article
- Effect of rivaroxaban versus warfarin on health care costs among nonvalvular atrial fibrillation patients: observations from rivaroxaban users and matched warfarin users.Advances in therapy · 2015Article
- Edoxaban versus warfarin for stroke prevention in non-valvular atrial fibrillation: a cost-effectiveness analysis.Journal of thrombosis and thrombolysis · 2015Article
- Cost-effectiveness of anticoagulation in patients with nonvalvular atrial fibrillation with edoxaban compared to warfarin in Germany.BioMed research international · 2015Article
- Cost effectiveness of new oral anticoagulants for stroke prevention in patients with atrial fibrillation in two different European healthcare settings.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2014Article
- Potential use of NOACs in developing countries: pros and cons.European journal of clinical pharmacology · 2014Review
- Economic evaluation of warfarin, dabigatran, rivaroxaban, and apixaban for stroke prevention in atrial fibrillation.PharmacoEconomics · 2014Article
- The economic burden to medicare of stroke events in atrial fibrillation populations with and without thromboprophylaxis.Population health management · 2014Article
- Anticoagulation in atrial fibrillation.BMJ (Clinical research ed.) · 2014Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo conduct a systematic review of economic models of newer anticoagulants for stroke prevention in atrial fibrillation (SPAF). PATIENTS AND
methodsWe searched Medline, Embase, NHSEED and HTA databases and the Tuft's Registry from January 1, 2008 through October 10, 2012 to identify economic (Markov or discrete event simulation) models of newer agents for SPAF.
resultsEighteen models were identified. Each was based on a lone randomized trial/new agent, and these trials were clinically and methodologically heterogeneous. Dabigatran 150 mg, 110 mg and sequentially-dosed were assessed in 9, 8, and 9 models, rivaroxaban in 4 and apixaban in 4. Warfarin was a first-line comparator in 94% of models. Models were conducted from United States (44%), European (39%) and Canadian (17%) perspectives. Models typically assumed patients between 65-73 years old at moderate-risk of stroke initiated anticoagulation for/near a lifetime. All models reported cost/quality-adjusted life-year, 22% reported using a societal perspective, but none included indirect costs. Four models reported an incremental cost-effectiveness ratio (ICER) for a newer anticoagulant (dabigatran 110 mg (n = 4)/150 mg (n = 2); rivaroxaban (n = 1)) vs. warfarin above commonly reported willingness-to-pay thresholds. ICERs vs. warfarin ranged from $3,547-$86,000 for dabigatran 150 mg, $20,713-$150,000 for dabigatran 110 mg, $4,084-$21,466 for sequentially-dosed dabigatran and $23,065-$57,470 for rivaroxaban. Apixaban was found economically-dominant to aspirin, and dominant or cost-effective ($11,400-$25,059) vs. warfarin. Indirect comparisons from 3 models suggested conflicting comparative cost-effectiveness results.
conclusionsCost-effectiveness models frequently found newer anticoagulants cost-effective, but the lack of head-to-head trials and the heterogeneous characteristics of underlying trials and modeling methods make it difficult to determine the most cost-effective agent.
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