Evidence map›Paper›PMID 38153624›Full record

Trial reportAmerican journal of cardiovascular drugs : drugs, devices, and other interventions2024

The Cost-Effectiveness of Rivaroxaban Plus Aspirin Compared with Aspirin Alone in the COMPASS Trial: A US Perspective.

Andre Lamy, John Eikelboom, Wesley Tong, Fei Yuan, Shrikant I Bangdiwala, Jackie Bosch, Stuart Connolly, Eva Lonn, Gilles R Dagenais, Kelley R H Branch and 11 more

Registry-linked trialAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in American journal of cardiovascular drugs : drugs, devices, and other interventions, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01776424 (A Randomized Controlled Trial of Rivaroxaban for the Prevention of Major Cardiovascular Events in Patients With Coronary or Peripheral Artery Disease), which is not on this 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
–field-weighted citation impact
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.

NCT01776424 phase3completednot on this map

A Randomized Controlled Trial of Rivaroxaban for the Prevention of Major Cardiovascular Events in Patients With Coronary or Peripheral Artery Disease (COMPASS - Cardiovascular OutcoMes for People Using Anticoagulation StrategieS).

TypeinterventionalSponsorBayerRan2013 to 2021Enrolled27,395ConditionsPrevention & ControlArmsRivaroxaban (Xarelto, BAY59-7939), Aspirin, Aspirin placebo, Rivaroxaban placebo, Pantoprazole
3 · Its place in the literature

Who cites it

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

  1. Pooled it
  2. Temporal trends in the prescription of low-dose antithrombotic and anti-inflammatory therapies in Germany (2022-2024).Clinical research in cardiology : official journal of the German Cardiac Society · 2026
    Article
  3. Review
  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

21 authors.

Andre LamyPopulation Health Research Institute, McMaster University, Hamilton, ON, Canada. alamy1@mac.com.ORCID http://orcid.org/0000-0003-2777-7621
John EikelboomPopulation Health Research Institute, McMaster University, Hamilton, ON, Canada.
Wesley TongPopulation Health Research Institute, McMaster University, Hamilton, ON, Canada.
Fei YuanPopulation Health Research Institute, McMaster University, Hamilton, ON, Canada.
Shrikant I BangdiwalaPopulation Health Research Institute, McMaster University, Hamilton, ON, Canada.
Jackie BoschPopulation Health Research Institute, McMaster University, Hamilton, ON, Canada.
Stuart ConnollyPopulation Health Research Institute, McMaster University, Hamilton, ON, Canada.
Eva LonnPopulation Health Research Institute, McMaster University, Hamilton, ON, Canada.
Gilles R DagenaisInstitut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC, Canada.
Kelley R H BranchUniversity of Washington Medical Center, Seattle, WA, USA.
Wei-Jhih WangComparative Health Outcomes, Policy and Economics Institute, School of Pharmacy, University of Washington, Seattle, WA, USA.
Deepak L BhattMount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Jeffrey ProbstfieldUniversity of Washington, Seattle, USA.
Georg ErtlUniversity of Würzburg, Würzburg, Germany.
Stefan StörkDepartment of Clinical Research & Epidemiology, Comprehensive Heart Failure Center, and Department of Internal Medicine I, University Hospital, Würzburg, Germany.
P Gabriel StegINSERMU-1148 and FACT (French Alliance for Cardiovascular Trials), Université Paris-Cité, Paris, France.
Victor AboyansInserm U1094 & IRD 270, Limoges University, and Department of Cardiology, Dupuytren University Hospital, Limoges, France.
Isabelle Durand-ZaleskiAssistance Publique Hôpitaux de Paris, URC Eco and Santé Publique, Hôpital Henri Mondor, Créteil, France.
Lars RydenDepartment of Medicine K2, Karolinska Institutet, Stockholm, Sweden.
Salim YusufPopulation Health Research Institute, McMaster University, Hamilton, ON, Canada.
COMPASS Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRivaroxaban 2.5 mg twice daily with aspirin 100 mg daily was shown to be better than aspirin 100 mg daily for preventing cardiovascular (CV) death, stroke or myocardial infarction in patients with either stable coronary artery disease (CAD) or peripheral artery disease (PAD). The cost-effectiveness of this regimen in this population is essential for decision-makers to know.

methodsUS direct healthcare system costs (in USD) were applied to hospitalized events, procedures and study drugs utilized by all patients. We determined the mean cost per participant for the full duration of the trial (mean follow-up of 23 months) plus quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) over a lifetime using a two-state Markov model with 1-year cycle length. Sensitivity analyses were performed on the price of rivaroxaban and the annual discontinuation rate.

resultsThe costs of events and procedures were reduced for Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) patients who received rivaroxaban 2.5 mg orally (BID) plus acetylsalicylic acid (ASA) compared with ASA alone. Total costs were higher for the combination group ($7426 versus $4173) after considering acquisition costs of the study drug. Over a lifetime, patients receiving rivaroxaban plus ASA incurred $27,255 more and gained 1.17 QALYs compared with those receiving ASA alone resulting in an ICER of $23,295/QALY. ICERs for PAD only and polyvascular disease subgroups were lower.

conclusionRivaroxaban 2.5 mg BID plus ASA compared with ASA alone was cost-effective (high value) in the USA. COMPASS ClinicalTrials.gov identifier: NCT01776424.

Indexed as

AspirinMyocardial InfarctionPeripheral Arterial DiseaseRivaroxabanCost-Benefit AnalysisDrug Therapy, CombinationFactor Xa InhibitorsHumansStrokeAspirinFactor Xa InhibitorsRivaroxaban

Identifiers

PMID38153624
PMCPMC10806169

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Registered trials

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.