This study was supported by the School of Pharmacy, The Chinese University of Hong Kong.
Cost-Effectiveness of Dabigatran Compared With Warfarin for Stroke Prevention in Patients With Atrial Fibrillation—A Real Patient Data Analysis in a Hong Kong Teaching Hospital
Article first published online: 14 MAR 2013
© 2013 Wiley Periodicals, Inc.
Volume 36, Issue 5, pages 280–285, May 2013
How to Cite
Chang, A. M., Ho, J. C. S., Yan, B. P., Yu, C. M., Lam, Y. Y. and Lee, V. W. Y. (2013), Cost-Effectiveness of Dabigatran Compared With Warfarin for Stroke Prevention in Patients With Atrial Fibrillation—A Real Patient Data Analysis in a Hong Kong Teaching Hospital. Clin Cardiol, 36: 280–285. doi: 10.1002/clc.22112
The authors have no funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 13 MAY 2013
- Article first published online: 14 MAR 2013
- Manuscript Accepted: 6 FEB 2013
- Manuscript Received: 18 OCT 2012
To compare the management cost and cost-effectiveness of dabigatran with warfarin in patients with nonvalvular atrial fibrillation (AF) from the hospital's and patients' perspectives.
Dabigatran is more cost-effective than warfarin for stroke prevention of AF in Hong Kong.
The analysis was performed in conjunction with a drug utilization evaluation of dabigatran study in a teaching hospital in Hong Kong. The study recruited 244 patients who received either dabigatran or warfarin for stroke prevention of AF. A cost-effectiveness analysis was performed and was expressed as an incremental cost-effectiveness ratio (ICER) in averting a cardiac event or a bleeding event. A sensitivity analysis was used on all relevant variables to test the robustness.
From the hospital's perspective, the dabigatran group had a lower total cost of management than that of the warfarin group (median: US$421 vs US$1306, P < 0.001) (US$1 = HK$7.75) and was dominant over warfarin. From the patients' perspective, the total cost of management in the dabigatran group was higher than that in warfarin group (median: US$1751 vs US$70, P < 0.001), and the ICER in preventing a cardiac or bleeding event of dabigatran vs warfarin was estimated at US$68 333 and US$20 500, respectively. If dabigatran was subsidized by the hospital, a higher cost would be incurred by the hospital (median: US$1679 vs US$1306, ICER (cardiac and bleeding events): US$15 163 and US$4549, respectively).
The study favored dabigatran for stroke prophylaxis in patients with nonvalvular AF in Hong Kong under the current hospital's perspective and provided a reference for further comparisons under patient and subsidization perspectives.