Evidence map›Paper›PMID 26832316›Full record

ArticleAtencion primaria

[Cost-effectiveness analysis of apixaban versus acetylsalicylic acid in the prevention of stroke in patients with non-valvular atrial fibrillation in Spain].

Ginés Escolar-Albaladejo, Gonzalo Barón-Esquivias, José Luis Zamorano, Lourdes Betegón-Nicolás, Cristina Canal-Fontcuberta, Marina de Salas-Cansado, Darío Rubio-Rodríguez, Carlos Rubio-Terrés

Open access · goldAbstract readComparative Study
In one paragraph

Article in Atencion primaria. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 31% 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Observational
  3. Article
  4. Article
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

8 authors at 5 institutions in 1 country.

Ginés Escolar-AlbaladejoHospital Clínic, Barcelona, España.
Gonzalo Barón-EsquiviasHospital Universitario Virgen del Rocío, Sevilla, España.
José Luis ZamoranoHospital Universitario Ramón y Cajal, Madrid, España.
Lourdes Betegón-NicolásDepartamento de Economía de la Salud, Bristol-Myers Squibb España, Madrid, España.
Cristina Canal-FontcubertaDepartamento de Economía de la Salud, Bristol-Myers Squibb España, Madrid, España.
Marina de Salas-CansadoPfizer España, Madrid, España.
Darío Rubio-RodríguezHealth Value, Madrid, España.
Carlos Rubio-TerrésHealth Value, Madrid, España. Electronic address: crubioterres@healthvalue.org.
Madrid Health Service · ESHospital Clínic de Barcelona · ESHospital Universitario Ramón y Cajal · ESHospital Universitario Virgen del Rocío · ESPfizer (Spain) · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess the cost-effectiveness of apixaban versus acetylsalicylic acid (ASA) in stroke prevention in patients with non-valvular atrial fibrillation (NVAF) with contraindications of vitamin K antagonists in Spain.

methodsA Markov model was adapted, simulating the patient's lifetime. The safety and efficacy of the drugs were obtained from AVERROES clinical trial. The analysis was done from the Spanish National Health System (NHS) and societal perspective. The cost of drugs was calculated according to the recommended doses. The cost of NVAF complications and disease management was obtained from Spanish sources.

resultsIn a cohort of 1,000 patients with NVAF, during their lifetime numerous complications could be avoided with apixaban versus ASA (48 ischemic strokes, 10 systemic embolism and 53 related deaths). In each patient treated with apixaban more life-years (0.303 LYG) and more quality-adjusted life-years (0.277 QALYs) could be gained. Apixaban would generate more costs per patient for the NHS (€1,742 per patient) but savings would result from the social perspective (€2,887 saved per patient). The cost per LYG and QALY gained would be of €5,749 and €6,289 for the NHS. Apixaban would be dominant (more effective with less costs than ASA) from the societal perspective. The results were stable in both deterministic and probabilistic sensitivity analyses.

conclusionsAccording to this model, when costs and estimated lifetime outcomes achieved with apixaban are compared with those of ASA, apixaban was assessed to be a cost-effective treatment for the prevention of stroke in patients with NVAF in Spain.

Indexed as

AgedAspirinAtrial FibrillationCost-Benefit AnalysisFemaleHumansMaleMarkov ChainsPyrazolesPyridonesSpainStrokeapixabanAspirinPyrazolesPyridonesAcetylsalicylic acidÁcido acetilsalicílicoApixabanApixabánCost-effectivenessCoste-utilidadFibrilación auricular no valvularNon-valvular atrial fibrillation

Identifiers

PMID26832316
PMCPMC6877843
OpenAlexW2291462850

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.