Evidence map›Paper›PMID 41057675›Full record

ArticleDrugs - real world outcomes2025

Cost Differences Between Oral Anticoagulation Therapies in Patients with Atrial Fibrillation in Finland.

Ossi Lehtonen, Olli Halminen, K E Juhani Airaksinen, Jari Haukka, Jukka Putaala, Pirjo Mustonen, Konsta Teppo, Elis Kouki, Aapo L Aro, Juha Hartikainen and 2 more

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

Article in Drugs - real world outcomes, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04645537 (Finnish AntiCoagulation in Atrial Fibrillation), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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.

NCT04645537 completednot on this map

Finnish AntiCoagulation in Atrial Fibrillation (FinACAF)

TypeobservationalSponsorHelsinki University Central HospitalRan2011 to 2018Enrolled400,000ConditionsAtrial Fibrillation
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Ossi LehtonenUniversity of Eastern Finland, Kuopio, Finland. ossi.lehtonen@uef.fi.ORCID http://orcid.org/0009-0009-4914-1027
Olli HalminenUniversity of Eastern Finland, Kuopio, Finland.ORCID http://orcid.org/0000-0001-9266-8435
K E Juhani AiraksinenHeart Center, Turku University Hospital and University of Turku, Turku, Finland.ORCID http://orcid.org/0000-0002-0193-568X
Jari HaukkaFaculty of Medicine, University of Helsinki, Helsinki, Finland.ORCID http://orcid.org/0000-0003-1450-6208
Jukka PutaalaDepartment of Neurology, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland.ORCID http://orcid.org/0000-0002-6630-6104
Pirjo MustonenHeart Center, Turku University Hospital and University of Turku, Turku, Finland.ORCID http://orcid.org/0000-0003-1319-0248
Konsta TeppoHeart Center, Turku University Hospital and University of Turku, Turku, Finland.ORCID http://orcid.org/0000-0002-4460-0994
Elis KoukiUniversity of Eastern Finland, Kuopio, Finland.ORCID http://orcid.org/0000-0002-5759-0916
Aapo L AroHeart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.ORCID http://orcid.org/0000-0001-7030-6740
Juha HartikainenHeart Center, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.ORCID http://orcid.org/0000-0003-0847-107X
Mika LehtoJorvi Hospital, Department of Internal Medicine, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland.ORCID http://orcid.org/0000-0002-8691-5142
Miika LinnaUniversity of Eastern Finland, Kuopio, Finland.ORCID http://orcid.org/0000-0002-7660-2484

Funding

Helsingin ja Uudenmaan Sairaanhoitopiiri TYH2019309Helsingin ja Uudenmaan Sairaanhoitopiiri TYH2023319
6 · The paper itself

Abstract

backgroundThe cost burden of new-onset atrial fibrillation (AF) has not previously been studied with unselected nationwide data.

objectiveWe analyzed differences in the distribution and time course of costs from all categories of healthcare services in patients receiving direct oral anticoagulants (DOACs), warfarin, or no anticoagulation during the first year following diagnosis of AF.

methodsThis sub-study of the Finnish AntiCoagulation in Atrial Fibrillation (FinACAF) project comprised all new-onset AF patients from 2011 to 2017 in Finland with an indication for oral anticoagulation treatment. The registry data included information on primary and secondary care services as well as social care services, drug purchases, laboratory data, and reimbursed private care and travel services. We report inverse probability of treatment weighted average costs for different pharmaceutical groups with bootstrapped confidence intervals.

resultsIn total, 130,745 patients (66,610 on warfarin, 32,996 on DOACs) were included. Weighted first-year costs after onset of AF were €11,364 for rivaroxaban (n = 13,230), €12,642 for apixaban (n = 11,886), €11,403 for dabigatran (n = 7514), and €10,752 for edoxaban (n = 366). Costs were clustered near the diagnosis of AF. Costs for warfarin patients were inversely related to the quality of anticoagulation therapy. Average first-year costs for warfarin patients were €15,860, higher than for patients on DOACs by €3218-€5108. Patients without any oral anticoagulation had the highest first-year costs, €17,682. Patients with high risk of stroke had higher total costs, both in patients using DOACs and warfarin.

conclusionsDOACs had lower total costs than warfarin despite higher drug expenses. Patients without any oral anticoagulation had the highest costs. CLINICALTRIALS IDENTIFIER: NCT04645537. ENCEPP IDENTIFIER: EUPAS29845.

Identifiers

PMID41057675
PMCPMC12634970

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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.