Evidence map›Paper›PMID 28637460›Full record

ArticleHealth and quality of life outcomes2017

Healthcare utilization and costs for patients initiating Dabigatran or Warfarin.

Shannon L Reynolds, Sameer R Ghate, Richard Sheer, Pranav K Gandhi, Chad Moretz, Cheng Wang, Stephen Sander, Mary E Costantino, Srinivas Annavarapu, George Andrews

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Health and quality of life outcomes, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.9field-weighted citation impact, top 23% 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

5 citing papers in PubMed, 13 citations in OpenAlex.

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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

10 authors at 2 institutions in 1 country.

Shannon L ReynoldsComprehensive Health Insights, 315 W Market St., 7th Floor, Louisville, KY, 40202, USA. sreynolds7@humana.com.
Sameer R GhateBoehringer Ingelheim, Ridgefield, CT, USA.
Richard SheerComprehensive Health Insights, 315 W Market St., 7th Floor, Louisville, KY, 40202, USA.
Pranav K GandhiBoehringer Ingelheim, Ridgefield, CT, USA.
Chad MoretzComprehensive Health Insights, 315 W Market St., 7th Floor, Louisville, KY, 40202, USA.
Cheng WangBoehringer Ingelheim, Ridgefield, CT, USA.
Stephen SanderBoehringer Ingelheim, Ridgefield, CT, USA.
Mary E CostantinoComprehensive Health Insights, 315 W Market St., 7th Floor, Louisville, KY, 40202, USA.
Srinivas AnnavarapuComprehensive Health Insights, 315 W Market St., 7th Floor, Louisville, KY, 40202, USA.
George AndrewsHumana Inc, Louisville, KY, USA.
Boehringer Ingelheim (United States) · USHumana (United States) · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNovel oral anticoagulants (NOAC) such as dabigatran, when compared to warfarin, have been shown to potentially reduce the risk of stroke in patients with non-valvular atrial fibrillation (NVAF) together with lower healthcare resource utilization (HCRU) and similar total costs. This study expands on previous work by comparing HCRU and costs for patients newly diagnosed with NVAF and newly initiated on dabigatran or warfarin, and is the first study specifically in a Medicare population.

methodsA retrospective matched-cohort study was conducted using data from administrative health care claims during the study period 01/01/2010-12/31/2012. Cox regression analyses were used to compare all-cause risk of first hospitalizations and emergency room (ER) visits. Medical, pharmacy, and total costs per-patient-per-month (PPPM) were compared between dabigatran and warfarin users.

resultsA total of 1110 patients initiated on dabigatran were propensity score-matched with corresponding patients initiated on warfarin. The mean number of hospitalizations (0.92 vs. 1.13, P = 0.012), ER visits (1.32 vs. 1.56, P < 0.01), office visits (21.43 vs. 29.41; P < 0.01), and outpatient visits (10.86 vs. 22.02; P < 0.01) were lower among dabigatran compared to warfarin users. Patients initiated on dabigatran had significantly lower risk of first all-cause ER visits [hazard ratio (HR): 0.84, 95% confidence interval (CI): 0.73-0.98] compared to those initiated on warfarin. Adjusted mean pharmacy costs PPPM were significantly greater for dabigatran users ($510 vs. $250, P < 0.001); however, mean medical costs PPPM ($1912 vs. $1956, P = 0.55) and mean total costs PPPM ($2381 vs. $2183, P = 0.10) were not significantly different compared to warfarin users.

conclusionsDabigatran users had significantly lower HCRU compared to warfarin users. In addition, dabigatran users had lower risk of all-cause ER visits. Despite higher pharmacy costs, the two cohorts did not differ significantly in medical or total all-cause costs.

Indexed as

AgedAged, 80 and overAmbulatory CareAnticoagulantsAtrial FibrillationCosts and Cost AnalysisDabigatranFemaleHealth Care CostsHospitalizationHumansMaleMiddle AgedPatient Acceptance of Health CarePropensity ScoreProportional Hazards ModelsAnticoagulantsDabigatranWarfarinDabigatranHealthcare resource utilizationNon-valvular atrial fibrillationWarfarin

Identifiers

PMID28637460
PMCPMC5480105
OpenAlexW2656408530

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.