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February 26, 2007BMC Family PracticeOpen Access

The cost of monitoring warfarin in patients with chronic atrial fibrillation in primary care in Sweden

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Population

Patients with chronic atrial fibrillation on warfarin treatment managed in primary care in Sweden.

Design

Other

Key result

The mean cost of one INR control in primary care in Sweden was SEK 550, with mean costs during the first three months, first year, and second year of treatment estimated at SEK 6,811, SEK 16,244, and SEK 8,904 respectively.

Authors

IBIngela BjörholtSAStina AnderssonGNGunnar Nilsson

Discussion

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Overview

Substantial INR monitoring costs in Swedish primary care may inform local resource planning; observational data leaves open cost-effectiveness comparisons with alternatives.

Key Points

  • This study aims to estimate the health care costs associated with INR monitoring of warfarin treatment in patients with chronic atrial fibrillation in primary care settings in Sweden.
  • Analyzed data from two observational studies based on electronic patient records.
  • Utilized two Delphi-panel studies with multiple rounds to gather information.
  • Calculated unit costs from official databases and primary health care centers.
  • The average cost of one INR control was SEK 550.
  • Total costs for INR controls were SEK 6,811 in the first three months, SEK 16,244 in the first year, and SEK 8,904 in the second year.
  • Home care INR controls are particularly expensive but may prevent strokes, offsetting costs.

Study Design

Type

Observational

Multicenter

Yes

Structured PICO

P
Population
Health economic assessment estimating the cost of INR controls in patients with chronic atrial fibrillation on warfarin treatment managed in primary care in Sweden, based on retrospective patient record reviews and Delphi panels.
E
Exposure
INR controls (monitoring of warfarin) including preparations, direct patient time, follow-up, and laboratory tests.
O
Outcome
Health care cost of INR controls (per visit, first 3 months, first year, and subsequent years).

Monitoring warfarin in primary care incurs substantial health care costs, particularly during the initiation phase and when undertaken in home care, though these may be offset by stroke prevention.

Limitations

  • The frequency of visits based on patient records may be underestimated if INR controls were carried out elsewhere and omitted from the records.
  • The study did not include societal costs, such as costs incurred by patients or their care providers.
  • The cost of providing transportation for patients unable to organize their own travel to the primary health care center was not taken into consideration.
  • Frequency of visits based on patient records may be underestimated if controls were carried out elsewhere.
  • Did not include societal costs (costs incurred by patients or their care providers).
  • Did not include costs for transportation for patients unable to organize their own travel.

Cite This Study

Björholt et al. (2007) conducted an observational in Chronic atrial fibrillation. INR monitoring for warfarin treatment was evaluated on Mean cost of one INR control. The mean cost of one INR control in primary care in Sweden was SEK 550, with mean costs during the first three months, first year, and second year of treatment estimated at SEK 6,811, SEK 16,244, and SEK 8,904 respectively.

synapsesocial.com/papers/6a230db549ad601d9cd27737https://doi.org/10.1186/1471-2296-8-6
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