Dabigatran etexilate versus warfarin in management of non-valvular atrial fibrillation in UK context: quantitative benefit-harm and economic analyses
Key result
High-dose dabigatran (150 mg twice daily) provided an incremental net benefit of 0.146 QALYs compared with warfarin, but was not cost-effective at centers achieving good INR control.
Why the study?
Does dabigatran etexilate improve quality adjusted life years and cost-effectiveness compared with warfarin in patients with non-valvular atrial fibrillation?
Population
50,000 simulated patients with non-valvular atrial fibrillation at moderate to high risk of stroke with a…
Comparison
Dabigatran etexilate 110 mg and 150 mg twice daily vs Warfarin
Design
Other
Follow-up
lifetime horizon
Authors
Discussion
Loading...
Member takes
Implication
Supports dabigatran as potentially cost-effective vs warfarin in UK AF; leaves open whether model assumptions translate to real-world practice.
Structured PICO
Does dabigatran etexilate improve quality adjusted life years and cost-effectiveness compared with warfarin in patients with non-valvular atrial fibrillation?
P
Population
50,000 simulated patients with non-valvular atrial fibrillation at moderate to high risk of stroke (mean CHADS2 score 2.1) modeled over a lifetime horizon.
I
Intervention
Dabigatran etexilate 110 mg and 150 mg twice daily
C
Comparator
Warfarin
O
Outcome
Quality adjusted life years (QALYs) gained and incremental cost per QALY
Main Result
Mean Difference: 0.146 (95% CI -0.029–0.322)
High-dose dabigatran is cost-effective compared to warfarin for stroke prevention in atrial fibrillation, except in settings with excellent INR control.
Cite This Study
Pink et al. (2011) studied non-valvular atrial fibrillation (n=50,000). Dabigatran etexilate vs. warfarin was evaluated on Quality adjusted life years (QALYs) gained and incremental cost per QALY (incremental net benefit 0.146 QALYs, 95% CI -0.029 to 0.322). High-dose dabigatran (150 mg twice daily) provided an incremental net benefit of 0.146 QALYs compared with warfarin, but was not cost-effective at centers achieving good INR control.