Cost-effectiveness of Apixaban for Stroke Prevention in Patients with Atrial Fibrillation in Algeria
**Background:** Atrial fibrillation (AF) is a chronic sustained heart rhythm disorder associated with an increased risk of stroke. Apixaban, a new oral anticoagulant, was approved by the European Medicines Agency for prevention of stroke in patients with AF. The efficacy of apixaban has been investi...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Columbia Data Analytics, LLC
2017-05-01
|
| Series: | Journal of Health Economics and Outcomes Research |
| Online Access: | https://doi.org/10.36469/9797 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1823860384029736960 |
|---|---|
| author | Yazid Aoudia Thitima Kongnakorn Evie Merinopoulou Mohamed Said Bettayeb Sid Ahmed Kherraf |
| author_facet | Yazid Aoudia Thitima Kongnakorn Evie Merinopoulou Mohamed Said Bettayeb Sid Ahmed Kherraf |
| author_sort | Yazid Aoudia |
| collection | DOAJ |
| description | **Background:** Atrial fibrillation (AF) is a chronic sustained heart rhythm disorder associated with an increased risk of stroke. Apixaban, a new oral anticoagulant, was approved by the European Medicines Agency for prevention of stroke in patients with AF. The efficacy of apixaban has been investigated in randomised controlled trials.
**Objectives:** The objective of this study was to estimate the economic implications of using apixaban compared to other anti-coagulations to reduce the risk of stroke in patients with AF from the perspective of the Algerian payer.
**Methods:** A previously published Markov model was adapted to the Algerian setting. The model included patients for whom vitamin K antagonist (VKA) treatment is suitable and could initiate on acenocoumarol, rivaroxaban or apixaban, and those unsuitable for VKA treatment who could initiate on aspirin or apixaban. Over a lifetime time horizon, costs were estimated in Algerian dinars (DZD) and outcomes included life-years (LYs), quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs).
**Results:** In the VKA suitable population, apixaban was estimated to be a dominant treatment option over rivaroxaban, providing a higher number of QALYs at lower costs, while when compared with acenocoumarol, an ICER of 3 672 059 DZD per QALY gained was estimated. Amongst those unsuitable for VKA therapy, the ICER was 2 061 863 DZD per QALY gained.
**Conclusion:** Apixaban was found to be a cost-effective choice for stroke prevention in patients with AF in Algeria compared to acenocoumarol and rivaroxaban in the VKA suitable population and compared to aspirin in the VKA unsuitable population. |
| format | Article |
| id | doaj-art-e5dbb9c469f34072ab96a5a163cef92d |
| institution | Kabale University |
| issn | 2327-2236 |
| language | English |
| publishDate | 2017-05-01 |
| publisher | Columbia Data Analytics, LLC |
| record_format | Article |
| series | Journal of Health Economics and Outcomes Research |
| spelling | doaj-art-e5dbb9c469f34072ab96a5a163cef92d2025-02-10T16:12:41ZengColumbia Data Analytics, LLCJournal of Health Economics and Outcomes Research2327-22362017-05-0151Cost-effectiveness of Apixaban for Stroke Prevention in Patients with Atrial Fibrillation in AlgeriaYazid AoudiaThitima KongnakornEvie MerinopoulouMohamed Said BettayebSid Ahmed Kherraf**Background:** Atrial fibrillation (AF) is a chronic sustained heart rhythm disorder associated with an increased risk of stroke. Apixaban, a new oral anticoagulant, was approved by the European Medicines Agency for prevention of stroke in patients with AF. The efficacy of apixaban has been investigated in randomised controlled trials. **Objectives:** The objective of this study was to estimate the economic implications of using apixaban compared to other anti-coagulations to reduce the risk of stroke in patients with AF from the perspective of the Algerian payer. **Methods:** A previously published Markov model was adapted to the Algerian setting. The model included patients for whom vitamin K antagonist (VKA) treatment is suitable and could initiate on acenocoumarol, rivaroxaban or apixaban, and those unsuitable for VKA treatment who could initiate on aspirin or apixaban. Over a lifetime time horizon, costs were estimated in Algerian dinars (DZD) and outcomes included life-years (LYs), quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs). **Results:** In the VKA suitable population, apixaban was estimated to be a dominant treatment option over rivaroxaban, providing a higher number of QALYs at lower costs, while when compared with acenocoumarol, an ICER of 3 672 059 DZD per QALY gained was estimated. Amongst those unsuitable for VKA therapy, the ICER was 2 061 863 DZD per QALY gained. **Conclusion:** Apixaban was found to be a cost-effective choice for stroke prevention in patients with AF in Algeria compared to acenocoumarol and rivaroxaban in the VKA suitable population and compared to aspirin in the VKA unsuitable population.https://doi.org/10.36469/9797 |
| spellingShingle | Yazid Aoudia Thitima Kongnakorn Evie Merinopoulou Mohamed Said Bettayeb Sid Ahmed Kherraf Cost-effectiveness of Apixaban for Stroke Prevention in Patients with Atrial Fibrillation in Algeria Journal of Health Economics and Outcomes Research |
| title | Cost-effectiveness of Apixaban for Stroke Prevention in Patients with Atrial Fibrillation in Algeria |
| title_full | Cost-effectiveness of Apixaban for Stroke Prevention in Patients with Atrial Fibrillation in Algeria |
| title_fullStr | Cost-effectiveness of Apixaban for Stroke Prevention in Patients with Atrial Fibrillation in Algeria |
| title_full_unstemmed | Cost-effectiveness of Apixaban for Stroke Prevention in Patients with Atrial Fibrillation in Algeria |
| title_short | Cost-effectiveness of Apixaban for Stroke Prevention in Patients with Atrial Fibrillation in Algeria |
| title_sort | cost effectiveness of apixaban for stroke prevention in patients with atrial fibrillation in algeria |
| url | https://doi.org/10.36469/9797 |
| work_keys_str_mv | AT yazidaoudia costeffectivenessofapixabanforstrokepreventioninpatientswithatrialfibrillationinalgeria AT thitimakongnakorn costeffectivenessofapixabanforstrokepreventioninpatientswithatrialfibrillationinalgeria AT eviemerinopoulou costeffectivenessofapixabanforstrokepreventioninpatientswithatrialfibrillationinalgeria AT mohamedsaidbettayeb costeffectivenessofapixabanforstrokepreventioninpatientswithatrialfibrillationinalgeria AT sidahmedkherraf costeffectivenessofapixabanforstrokepreventioninpatientswithatrialfibrillationinalgeria |