Evidence map›Paper›PMID 24135964›Full record

ArticleClinical drug investigation2014

Apixaban, dabigatran, and rivaroxaban versus warfarin for stroke prevention in non-valvular atrial fibrillation: a cost-effectiveness analysis.

Carla Rognoni, Monia Marchetti, Silvana Quaglini, Nicola Lucio Liberato

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Clinical drug investigation, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 4 pooled it
6.5field-weighted citation impact, top 3% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 4 syntheses or guidelines pooled it, 64 citations in OpenAlex.

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  9. The contribution of real-world evidence to cost-effectiveness analysis: case study of Dabigatran etexilate in France.The European journal of health economics : HEPAC : health economics in prevention and care · 2020
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  18. Non-vitamin K antagonist oral anticoagulants and atrial fibrillation guidelines in practice: barriers to and strategies for optimal implementation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2015
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

Carla RognoniDepartment of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy.
Monia Marchetti
Silvana Quaglini
Nicola Lucio Liberato
University of Pavia · ITAzienda Sanitaria Locale di Asti · ITAzienda Socio Sanitaria Territoriale di Pavia

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectiveNon-valvular atrial fibrillation (NVAF) increases the risk of systemic thromboembolic events; therefore, anticoagulant treatment with vitamin K antagonists is widely prescribed. Recently, new oral anticoagulants (NOAs) directly inhibiting thrombin (dabigatran) or factor Xa (rivaroxaban and apixaban) demonstrated their non-inferiority with respect to warfarin in reducing the thromboembolic risk. The aim of this study was to estimate the cost effectiveness of NOAs in an Italian setting.

methodsA Markov decision model including ten health states and death was developed, and a 3-month Markov cycle and lifetime horizon were adopted. Transition probabilities and quality of life were estimated from three randomized trials and from additional reports in the literature. Analysis was performed in the context of the Italian National Health System. First- and second-order sensitivity analyses were made to test the robustness of the results. The mean European cost of dabigatran (<euro>2.58/day) was assigned to each NOA.

resultsThe incremental cost-utility ratio was below <euro>25,000/quality-adjusted life-year (QALY) gained for each NOA and each CHADS2 level, but differences among drugs were found. This result was sensitive to the time in (warfarin) therapeutic range and time horizon.

conclusionsOur analysis suggests that NOAs are a cost-effective treatment for the prevention of stroke in patients with NVAF in the Italian healthcare setting.

Indexed as

AgedAnticoagulantsAntithrombinsAtrial FibrillationBenzimidazolesbeta-AlanineCost-Benefit AnalysisDabigatranDrug CostsFactor Xa InhibitorsHealth Care CostsHumansItalyMarkov ChainsMorpholinesPyrazolesAnticoagulantsAntithrombinsapixabanBenzimidazolesbeta-AlanineDabigatranFactor Xa InhibitorsMorpholinesPyrazolesPyridonesRivaroxabanThiophenesWarfarin

Identifiers

PMID24135964
OpenAlexW2084649840

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.