Cost-effectiveness of Apixaban Compared With Edoxaban for Stroke Prevention in Nonvalvular Atrial Fibrillation

Gregory Y H Lip; Tereza Lanitis; Thitima Kongnakorn; Hemant Phatak; Corina Chalkiadaki; Xianchen Liu; Andreas Kuznik; Jack Lawrence; Paul Dorian

doi:10.1016/j.clinthera.2015.09.005

Cost-effectiveness of Apixaban Compared With Edoxaban for Stroke Prevention in Nonvalvular Atrial Fibrillation

Gregory Y H Lip, Tereza Lanitis, Thitima Kongnakorn, Hemant Phatak, Corina Chalkiadaki, Xianchen Liu, Andreas Kuznik, Jack Lawrence, Paul Dorian

Research output: Contribution to journal › Journal article › Research › peer-review

7 Citations (Scopus)

Abstract

PURPOSE: The purpose of this analysis was to assess the cost-effectiveness of apixaban 5 mg BID versus high- and low-dose edoxaban (60 mg and 30 mg once daily) as intended starting dose strategies for stroke prevention in patients from a UK National Health Service perspective.

METHODS: A previously developed and validated Markov model was adapted to evaluate the lifetime clinical and economic impact of apixaban 5 mg BID versus edoxaban (high and low dose) in patients with nonvalvular atrial fibrillation. A pairwise indirect treatment comparison was conducted for clinical end points, and price parity was assumed between apixaban and edoxaban. Costs in 2012 British pounds, life-years, and quality-adjusted life-years (QALYs) gained, discounted at 3.5% per annum, were estimated.

FINDINGS: Apixaban was predicted to increase life expectancy and QALYs versus low- and high-dose edoxaban. These gains were achieved at cost-savings versus low-dose edoxaban, thus being dominant and nominal increases in costs versus high-dose edoxaban. The incremental cost-effectiveness ratio of apixaban versus high-dose edoxaban was £6763 per QALY gained.

IMPLICATIONS: Apixaban was deemed to be dominant (less costly and more effective) versus low-dose edoxaban and a cost-effective alternative to high-dose edoxaban.

Original language	English
Journal	Clinical Therapeutics
Volume	37
Issue number	11
Pages (from-to)	2476-2488.e27
Number of pages	13
ISSN	0149-2918
DOIs	https://doi.org/10.1016/j.clinthera.2015.09.005
Publication status	Published - 2015

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@article{19b7160344df400895091de05dc08664,

title = "Cost-effectiveness of Apixaban Compared With Edoxaban for Stroke Prevention in Nonvalvular Atrial Fibrillation",

abstract = "PURPOSE: The purpose of this analysis was to assess the cost-effectiveness of apixaban 5 mg BID versus high- and low-dose edoxaban (60 mg and 30 mg once daily) as intended starting dose strategies for stroke prevention in patients from a UK National Health Service perspective.METHODS: A previously developed and validated Markov model was adapted to evaluate the lifetime clinical and economic impact of apixaban 5 mg BID versus edoxaban (high and low dose) in patients with nonvalvular atrial fibrillation. A pairwise indirect treatment comparison was conducted for clinical end points, and price parity was assumed between apixaban and edoxaban. Costs in 2012 British pounds, life-years, and quality-adjusted life-years (QALYs) gained, discounted at 3.5% per annum, were estimated.FINDINGS: Apixaban was predicted to increase life expectancy and QALYs versus low- and high-dose edoxaban. These gains were achieved at cost-savings versus low-dose edoxaban, thus being dominant and nominal increases in costs versus high-dose edoxaban. The incremental cost-effectiveness ratio of apixaban versus high-dose edoxaban was £6763 per QALY gained.IMPLICATIONS: Apixaban was deemed to be dominant (less costly and more effective) versus low-dose edoxaban and a cost-effective alternative to high-dose edoxaban.",

author = "Lip, {Gregory Y H} and Tereza Lanitis and Thitima Kongnakorn and Hemant Phatak and Corina Chalkiadaki and Xianchen Liu and Andreas Kuznik and Jack Lawrence and Paul Dorian",

year = "2015",

doi = "10.1016/j.clinthera.2015.09.005",

language = "English",

volume = "37",

pages = "2476--2488.e27",

journal = "Clinical Therapeutics",

issn = "0149-2918",

publisher = "Elsevier",

number = "11",

}

TY - JOUR

T1 - Cost-effectiveness of Apixaban Compared With Edoxaban for Stroke Prevention in Nonvalvular Atrial Fibrillation

AU - Lip, Gregory Y H

AU - Lanitis, Tereza

AU - Kongnakorn, Thitima

AU - Phatak, Hemant

AU - Chalkiadaki, Corina

AU - Liu, Xianchen

AU - Kuznik, Andreas

AU - Lawrence, Jack

AU - Dorian, Paul

PY - 2015

Y1 - 2015

N2 - PURPOSE: The purpose of this analysis was to assess the cost-effectiveness of apixaban 5 mg BID versus high- and low-dose edoxaban (60 mg and 30 mg once daily) as intended starting dose strategies for stroke prevention in patients from a UK National Health Service perspective.METHODS: A previously developed and validated Markov model was adapted to evaluate the lifetime clinical and economic impact of apixaban 5 mg BID versus edoxaban (high and low dose) in patients with nonvalvular atrial fibrillation. A pairwise indirect treatment comparison was conducted for clinical end points, and price parity was assumed between apixaban and edoxaban. Costs in 2012 British pounds, life-years, and quality-adjusted life-years (QALYs) gained, discounted at 3.5% per annum, were estimated.FINDINGS: Apixaban was predicted to increase life expectancy and QALYs versus low- and high-dose edoxaban. These gains were achieved at cost-savings versus low-dose edoxaban, thus being dominant and nominal increases in costs versus high-dose edoxaban. The incremental cost-effectiveness ratio of apixaban versus high-dose edoxaban was £6763 per QALY gained.IMPLICATIONS: Apixaban was deemed to be dominant (less costly and more effective) versus low-dose edoxaban and a cost-effective alternative to high-dose edoxaban.

AB - PURPOSE: The purpose of this analysis was to assess the cost-effectiveness of apixaban 5 mg BID versus high- and low-dose edoxaban (60 mg and 30 mg once daily) as intended starting dose strategies for stroke prevention in patients from a UK National Health Service perspective.METHODS: A previously developed and validated Markov model was adapted to evaluate the lifetime clinical and economic impact of apixaban 5 mg BID versus edoxaban (high and low dose) in patients with nonvalvular atrial fibrillation. A pairwise indirect treatment comparison was conducted for clinical end points, and price parity was assumed between apixaban and edoxaban. Costs in 2012 British pounds, life-years, and quality-adjusted life-years (QALYs) gained, discounted at 3.5% per annum, were estimated.FINDINGS: Apixaban was predicted to increase life expectancy and QALYs versus low- and high-dose edoxaban. These gains were achieved at cost-savings versus low-dose edoxaban, thus being dominant and nominal increases in costs versus high-dose edoxaban. The incremental cost-effectiveness ratio of apixaban versus high-dose edoxaban was £6763 per QALY gained.IMPLICATIONS: Apixaban was deemed to be dominant (less costly and more effective) versus low-dose edoxaban and a cost-effective alternative to high-dose edoxaban.

U2 - 10.1016/j.clinthera.2015.09.005

DO - 10.1016/j.clinthera.2015.09.005

M3 - Journal article

C2 - 26477648

SN - 0149-2918

VL - 37

SP - 2476-2488.e27

JO - Clinical Therapeutics

JF - Clinical Therapeutics

IS - 11

ER -