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.
Observational
Yes
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.
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Substantial INR monitoring costs in Swedish primary care may inform local resource planning; observational data leaves open cost-effectiveness comparisons with alternatives.
BACKGROUND: Warfarin is used for the prevention of stroke in chronic atrial fibrillation. The product has a narrow therapeutic index and to obtain treatment success, patients must be maintained within a given therapeutic range (International Normalised Ratio;INR). To ensure a wise allocation of health care resources, scrutiny of costs associated with various treatments is justified. The objective of this study was to estimate the health care cost of INR controls in patients on warfarin treatment with chronic atrial fibrillation in primary care in Sweden. METHODS: Data from various sources were applied in the analysis. Resource consumption was derived from two observational studies based on electronic patient records and two Delphi-panel studies performed in two and three rounds, respectively. Unit costs were taken from official databases and primary health care centres. RESULTS: The mean cost of one INR control was SEK 550. The mean costs of INR controls during the first three months, the first year and during the second year of treatment were SEK 6,811, SEK 16,244 and SEK 8,904 respectively. CONCLUSION: INR controls of patients on warfarin treatment in primary care in Sweden represent a substantial cost to the health care provider and they are particularly costly when undertaken in home care. The cost may however be off-set by the reduced incidence of stroke.
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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.
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