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Volume 8
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10.1080/20016689.2020.1782164
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Journal of Market Access & Health Policy (JMAHP) is published by MDPI from Volume 12 Issue 1 (2024). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Taylor & Francis.
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Article

Real-World Cost-Effectiveness of Rivaroxaban and Apixaban vs VKA in Stroke Prevention in Non-Valvular Atrial Fibrillation in the UK †

by
Kevin Bowrin
1,*,‡,
Jean-Baptiste Briere
2,‡,
Pierre Levy
3,
Aurélie Millier
4,
Jean Tardu
4 and
Mondher Toumi
5
1
Bayer Plc, Reading, UK
2
Bayer AG, Berlin, Germany
3
Université Paris-Dauphine, PSL Research University, LEDa-LEGOS, Paris, France
4
Creativ-Ceutical, Paris, France
5
Aix-Marseille University, Marseille, France
*
Author to whom correspondence should be addressed.
†
This article has been republished with minor changes. These changes do not impact the academic content of the article.
‡
The first and the second author participated equally in the development of this manuscript.
J. Mark. Access Health Policy 2020, 8(1), 1782164; https://doi.org/10.1080/20016689.2020.1782164
Submission received: 11 February 2020 / Revised: 8 June 2020 / Accepted: 9 June 2020 / Published: 25 June 2020

Abstract

Background: Morbidity and mortality associated with non-valvular atrial fibrillation (NVAF) imposes a substantial economic burden on the UK healthcare system. Objectives: An existing Markov model was adapted to assess the real-world cost-effectiveness of rivaroxaban and apixaban, each compared with a vitamin K antagonist (VKA), for stroke prevention in patients with NVAF from the National Health Service (NHS) and personal and social services (PSS) perspective. Methods: The model considered a cycle length of 3 months over a lifetime horizon. All inputs were drawn from real-world evidence (RWE): baseline patient characteristics, clinical event and persistence rates, treatment effect (meta-analysis of RWE studies), utility values and resource use. Deterministic and probabilistic sensitivity analyses were performed. Results: The incremental cost per quality-adjusted life year was £14,437 for rivaroxaban, and £20,101 for apixaban, compared with VKA. The probabilities to be cost-effective compared with VKA were 90% and 81%, respectively for rivaroxaban and apixaban, considering a £20,000 threshold. In both comparisons, the results were most sensitive to clinical event rates. Conclusions: These results suggest that rivaroxaban and apixaban are cost-effective vs VKA, based on RWE, considering a £20,000 threshold, from the NHS and PSS perspective in the UK for stroke prevention in patients with NVAF. This economic evaluation may provide valuable information for decision-makers, in a context where RWE is more accessible and its value more acknowledged.
Keywords: anticoagulants; atrial fibrillation; cost-effectiveness; economic; real-world evidence; stroke prevention anticoagulants; atrial fibrillation; cost-effectiveness; economic; real-world evidence; stroke prevention

Share and Cite

MDPI and ACS Style

Bowrin, K.; Briere, J.-B.; Levy, P.; Millier, A.; Tardu, J.; Toumi, M. Real-World Cost-Effectiveness of Rivaroxaban and Apixaban vs VKA in Stroke Prevention in Non-Valvular Atrial Fibrillation in the UK. J. Mark. Access Health Policy 2020, 8, 1782164. https://doi.org/10.1080/20016689.2020.1782164

AMA Style

Bowrin K, Briere J-B, Levy P, Millier A, Tardu J, Toumi M. Real-World Cost-Effectiveness of Rivaroxaban and Apixaban vs VKA in Stroke Prevention in Non-Valvular Atrial Fibrillation in the UK. Journal of Market Access & Health Policy. 2020; 8(1):1782164. https://doi.org/10.1080/20016689.2020.1782164

Chicago/Turabian Style

Bowrin, Kevin, Jean-Baptiste Briere, Pierre Levy, Aurélie Millier, Jean Tardu, and Mondher Toumi. 2020. "Real-World Cost-Effectiveness of Rivaroxaban and Apixaban vs VKA in Stroke Prevention in Non-Valvular Atrial Fibrillation in the UK" Journal of Market Access & Health Policy 8, no. 1: 1782164. https://doi.org/10.1080/20016689.2020.1782164

APA Style

Bowrin, K., Briere, J. -B., Levy, P., Millier, A., Tardu, J., & Toumi, M. (2020). Real-World Cost-Effectiveness of Rivaroxaban and Apixaban vs VKA in Stroke Prevention in Non-Valvular Atrial Fibrillation in the UK. Journal of Market Access & Health Policy, 8(1), 1782164. https://doi.org/10.1080/20016689.2020.1782164

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