Evidence map›Paper›PMID 25326294›Full record

ArticleAmerican journal of cardiovascular drugs : drugs, devices, and other interventions2014

Cost effectiveness of new oral anticoagulants for stroke prevention in patients with atrial fibrillation in two different European healthcare settings.

Talitha I Verhoef, William K Redekop, Fazila Hasrat, Anthonius de Boer, Anke Hilse Maitland-van der Zee

Open access · hybridAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of cardiovascular drugs : drugs, devices, and other interventions, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 5 pooled it
3.4field-weighted citation impact, top 7% 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

20 citing papers in PubMed, 5 syntheses or guidelines pooled it, 47 citations in OpenAlex.

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  10. 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

5 authors at 2 institutions in 2 countries.

Talitha I VerhoefDivision of Pharmacoepidemiology and Clinical Pharmacology, Faculty of Science, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, P. O. Box 80 082, 3508 TB, Utrecht, The Netherlands, t.verhoef@ucl.ac.uk.
William K Redekop
Fazila Hasrat
Anthonius de Boer
Anke Hilse Maitland-van der Zee
Utrecht University · NLErasmus University Rotterdam · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesOur objectives were to investigate the cost effectiveness of apixaban, rivaroxaban, and dabigatran compared with coumarin derivatives for stroke prevention in patients with atrial fibrillation in a country with specialized anticoagulation clinics (the Netherlands) and in a country without these clinics (the UK).

methodsA decision-analytic Markov model was used to analyse the cost effectiveness of apixaban, rivaroxaban, and dabigatran compared with coumarin derivatives in the Netherlands and the UK over a lifetime horizon.

resultsIn the Netherlands, the use of rivaroxaban, apixaban, or dabigatran increased health by 0.166, 0.365, and 0.374 quality-adjusted life-years (QALYs) compared with coumarin derivatives, but also increased costs by <euro>5,681, <euro>4,754, and <euro>5,465, respectively. The incremental cost-effectiveness ratios (ICERs) were <euro>34,248, <euro>13,024, and <euro>14,626 per QALY gained. In the UK, health was increased by 0.302, 0.455, and 0.461 QALYs, and the incremental costs were similar for all three new oral anticoagulants (<euro>5,118-5,217). The ICERs varied from <euro>11,172 to 16,949 per QALY gained. In the Netherlands, apixaban had the highest chance (37 %) of being cost effective at a threshold of <euro>20,000; in the UK, this chance was 41 % for dabigatran. The quality of care, reflected in time in therapeutic range, had an important influence on the ICER.

conclusionsApixaban, rivaroxaban, and dabigatran are cost-effective alternatives to coumarin derivatives in the UK, while in the Netherlands, only apixaban and dabigatran could be considered cost effective. The cost effectiveness of the new oral anticoagulants is largely dependent on the setting and quality of local anticoagulant care facilities.

Indexed as

Administration, OralAgedAged, 80 and overAnticoagulantsAtrial FibrillationBenzimidazolesbeta-AlanineCost-Benefit AnalysisCoumarinsDabigatranHumansMarkov ChainsMiddle AgedMorpholinesNetherlandsPyrazolesAnticoagulantsapixabanBenzimidazolesbeta-AlanineCoumarinsDabigatranMorpholinesPyrazolesPyridonesRivaroxabanThiophenes

Identifiers

PMID25326294
PMCPMC4250561
OpenAlexW2115228767

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.