Skip Navigation

This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Request Permissions
Google Scholar
Right arrow Articles by Miller, P. S.J.
Right arrow Articles by Ögren, M.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Miller, P. S.J.
Right arrow Articles by Ögren, M.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oupjournals.org

Economic factors associated with antithrombotic treatments for stroke prevention in patients with atrial fibrillation

Paul S.J. Miller1,*, Michael F. Drummond2, Lars K. Langkilde3, John J.V. McMurray4 and Mats Ögren3

1AstraZeneca, HEOR/Medical Science, Parklands FE2 D/4, Alderley Park SK10 4TG, UK
2University of York, Heslington, UK
3AstraZeneca, Mölndal, Sweden
4Western Infirmary, Glasgow, UK

* Corresponding author. Tel: +44 1625 519944; fax: +44 1625 518537. E-mail address: paul.miller3{at}astrazeneca.com

Our objective is to summarize the key components of a health economic evaluation of antithrombotic treatments for stroke prevention in patients with atrial fibrillation (AF). The key drivers are the changes in cost and quality of life associated with: thromboembolic events; the antithrombotic drug and its management; and bleeding events. Data on costs and utilities associated with all three components are presented. In clinical trials, vitamin K antagonists (VKAs, e.g. warfarin) substantially reduce the risk of stroke in patients with AF. However, the high cost of stroke makes clinical effectiveness a key element in the economic evaluation of stroke prevention interventions. Clinical effectiveness is lower than efficacy in clinical trials because of the variable anticoagulant effect and significant underuse of VKA therapy. The pure cost implication of reduced clinical effectiveness is illustrated using published data to extrapolate from clinical trials to clinical practice. If VKA effectiveness equivalent to that seen in trials could be achieved, 13.79 strokes per 100 patients over 5 years could be avoided compared with the typical current treatment pattern. If we take the lifetime cost of stroke to be {euro}126 797 (based on a USA estimate), preventing these additional strokes will trigger lifetime cost savings of {euro}1.75 million. Health economic decision-making must balance these gains against the cost of drug and management of VKA therapy.

Key Words: Anticoagulants • Arrhythmia • Stroke • Prevention • Health economic analysis


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.