Evidence map›Paper›PMID 24221805›Full record

ArticleJournal of thrombosis and thrombolysis2014

Comparison of cost-effectiveness of anticoagulation with dabigatran, rivaroxaban and apixaban in patients with non-valvular atrial fibrillation across countries.

Martin Krejczy, Job Harenberg, Svetlana Marx, Konrad Obermann, Lutz Frölich, Martin Wehling

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Journal of thrombosis and thrombolysis, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 3 pooled it
4.2field-weighted citation impact, top 5% 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

19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 45 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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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

6 authors at 3 institutions in 1 country.

Martin KrejczyDepartment of Clinical Pharmacology, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Maybachstrasse 14, 68169, Mannheim, Germany.
Job Harenberg
Svetlana Marx
Konrad Obermann
Lutz Frölich
Martin Wehling
University Hospital Heidelberg · DEHeidelberg University · DEUniversity Medical Centre Mannheim · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We did a cost-utility analysis for the new oral anticoagulants (NOACs) in the German population based on the quality-adjusted life years (QALY), total costs, and incremental cost-effectiveness ratios (ICER). The aim of our investigation was to examine cost-utility for current German drug market costs and compared to other countries. Outcome data were taken from dabigatran's RE-LY, rivaroxaban's ROCKET AF, and apixaban's ARISTOTLE trials. A Markov decision model, the Monte Carlo simulation (MCS), and further sensitivity analyses were used to simulate comparisons between NOACs over a follow up period of 20 years. The main perspective used for the analyses is from a German public health care insurance perspective. The base-case analyses of a 65 years old person with a CHADS2 score >1 resulted in 7.56-7.64 QALYs gained for warfarin. NOACs added 0.04-0.19 QALYs. Total costs for warfarin ranged from 7622 to 9069<euro> and for NOACs from 19537 to 20048<euro>. The sensitivity analysis indicated that current German market costs for the NOACs exceed a willingness-to-pay threshold of (hypothetical) 50000<euro>/QALY in all treatment regimen. The MCS showed willingness-to-pay thresholds from 60500<euro>/QALY for apixaban to 278000<euro>/QALY for dabigatran 110 mg bid, with values for dabigatran 150 mg bid and rivaroxaban in between. In conclusion, from a German public health care insurance perspective current market costs are high in relation to the quality of life gained. These results from clinical studies (efficacy) remain to be confirmed under real life conditions (effectiveness).

Indexed as

AnticoagulantsBenzimidazolesModels, EconometricMorpholinesPyrazolesPyridonesThiophenesbeta-AlanineCosts and Cost AnalysisDabigatranFemaleGermanyHumansMaleRetrospective StudiesRivaroxabanAnticoagulantsapixabanBenzimidazolesbeta-AlanineDabigatranMorpholinesPyrazolesPyridonesRivaroxabanThiophenes

Identifiers

PMID24221805
OpenAlexW2085846274

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.