Key result
Low warfarin time in therapeutic range (<60%) was associated with significantly higher total all-cause healthcare encounters (70.2 vs. 56.1, p<0.001) and costs compared to high TTR (≥60%).
Why the study?
Does low warfarin TTR (<60%) increase healthcare resource utilization and costs compared to high TTR (≥60%) in patients with nonvalvular atrial fibrillation?
Cohort (n=2,951)
Does low warfarin TTR (<60%) increase healthcare resource utilization and costs compared to high TTR (≥60%) in patients with nonvalvular atrial fibrillation?
In patients with nonvalvular atrial fibrillation, poor warfarin control (TTR <60%) is associated with significantly higher healthcare resource utilization and costs compared to good control.
Answers are grounded in this paper and cite their sources.
Low TTR associated with higher AF costs; leaves open whether TTR optimization reduces utilization.
BACKGROUND: Warfarin is efficacious for reducing stroke risk among patients with nonvalvular atrial fibrillation (NVAF). However, the efficacy and safety of warfarin are influenced by its time in therapeutic range (TTR). OBJECTIVE: To assess differences in healthcare resource utilization and costs among NVAF patients with low (<60%) and high (≥60%) warfarin TTRs in an integrated delivery network (IDN) setting. METHODS: Patients with NVAF were identified from an electronic medical record database. Patients were required to have ≥6 international normalized prothrombin time ratio (INR) tests. NVAF patients were grouped into two cohorts: those with warfarin TTR <60% (low TTR) and those with warfarin TTR ≥60% (high TTR). Healthcare resource utilization and costs were evaluated during a 12 month follow-up period. Multivariable regressions were used to assess the impact of different warfarin TTRs on healthcare costs. RESULTS: Among the study population, greater than half (54%, n = 1595) had a low TTR, and 46% (n = 1356) had a high TTR. Total all-cause healthcare resource utilization was higher among patients in the low TTR cohort vs. the high TTR cohort (number of encounters: 70.2 vs. 56.1, p < 0.001). After adjusting for patient characteristics, total all-cause healthcare costs and stroke-related healthcare costs were $2398 (p < 0.001) and $687 (p = 0.02) higher, respectively, for patients in the low TTR cohort vs. the high TTR cohort. LIMITATIONS: In this retrospective study, we were only able to evaluate the association and not the causality between healthcare resource utilization and costs with the different warfarin TTRs. CONCLUSION: Many warfarin-treated NVAF patients have a low warfarin TTR. NVAF patients with low vs. patients with high warfarin TTR used healthcare resources to a greater extent, which was reflected in higher healthcare costs.
No takes yet. Share an insight, caveat, or question.
Deitelzweig et al. (2015) conducted a cohort in Nonvalvular atrial fibrillation (NVAF) (n=2,951). Low warfarin time in therapeutic range (TTR <60%) vs. High warfarin time in therapeutic range (TTR ≥60%) was evaluated on Total all-cause healthcare resource utilization (number of encounters) (p=< 0.001). Low warfarin time in therapeutic range (<60%) was associated with significantly higher total all-cause healthcare encounters (70.2 vs. 56.1, p<0.001) and costs compared to high TTR (≥60%).
Synapse has enriched 10 related papers. Consider them for comparative context: