Abstract
Clinical complications of long-term anticoagulation in patients with atrial fibrillation cause significant morbidity and have a substantial economic impact on the healthcare system. To assess the cost-benefit by implementing patient self-testing (PST) in German patients anticoagulated with vitamin K antagonists (VKA) compared to treatment with the new oral anticoagulant drugs (NOAC) apixaban, dabigatran, edoxaban, and rivaroxaban. A deterministic decision-analytic model was developed simulating the number of major bleedings, ischemic strokes, and hemorrhagic strokes and their associated costs by utilizing PST compared to those of treatment with NOAC. Data on the rates of these adverse events in both groups during the 1st year of treatment was taken from the NOAC approval studies. Direct costs were evaluated from the perspective of the Statutory Health Insurance (SHI) considering the use of resources directly related to PST testing and costs incurred by hospital treatment of the adverse events. Univariate sensitivity analysis was performed to examine the extent to which our calculations were affected by varying the parameters considered in our model within plausible extremes. To capture the interactions between multiple inputs, ...Continue Reading
References
Jul 24, 2001·The Annals of Thoracic Surgery·H Körtke, R Körfer
Feb 14, 2007·Archives of Internal Medicine·Harvey D WhiteGregory W Albers
Oct 29, 2008·Circulation·Stuart J ConnollyUNKNOWN ACTIVE W Investigators
Jan 29, 2010·Expert Opinion on Pharmacotherapy·Chee W Khoo, Gregory Y H Lip
Jun 30, 2011·Circulation. Cardiovascular Quality and Outcomes·Adam J RoseJeremy D Goldhaber-Fiebert
Aug 13, 2011·The New England Journal of Medicine·Manesh R PatelUNKNOWN ROCKET AF Investigators
Aug 30, 2011·European Heart Journal·Keith A A FoxRobert M Califf
May 12, 2012·Deutsches Ärzteblatt International·Renate B SchnabelStefan Blankenberg
Jun 14, 2012·Expert Opinion on Investigational Drugs·Sheila A Doggrell
Nov 21, 2013·The New England Journal of Medicine·Robert P GiuglianoUNKNOWN ENGAGE AF-TIMI 48 Investigators
Apr 22, 2014·PloS One·Michael NaglerWalter A Wuillemin
Jun 4, 2014·American Heart Journal·Supriya ShoreP Michael Ho
Jan 27, 2015·BMC Medicine·Jürgen H ProchaskaPhilipp S Wild
Apr 15, 2015·JAMA : the Journal of the American Medical Association·Supriya ShoreMintu P Turakhia
Aug 28, 2016·European Heart Journal·Paulus KirchhofUNKNOWN ESC Scientific Document Group
Sep 4, 2017·BMC Cardiovascular Disorders·Ryan T BorneP Michael Ho
May 12, 2018·Pragmatic and Observational Research·Sabrina MuellerUlf Maywald
Jun 18, 2018·European Journal of Clinical Pharmacology·Mariam UjeylIngrid Schubert
Oct 27, 2018·Scientific Reports·Erik Lerkevang GroveTorben Bjerregaard Larsen