Key result
Rivaroxaban plus aspirin dominates aspirin alone, saving ~$3800 in lifetime costs and increasing QALYs.
Why the study?
Rivaroxaban 2.5mg twice daily with aspirin 100mg daily was superior to aspirin alone in the COMPASS trial, but its cost-effectiveness in Scandinavia was unknown.
Answers are grounded in this paper and cite their sources.
Economic evaluation projects favorable lifetime cost-effectiveness for rivaroxaban plus aspirin in Scandinavian vascular disease patients, suggesting substantial long-term value.
OBJECTIVES: Rivaroxaban 2.5mg twice daily with aspirin 100mg daily was superior to aspirin 100mg daily in the COMPASS trial but the cost-effectiveness in Scandinavia is unknown. DESIGN: Mean lifetime costs (USDs) and quality-adjusted life-years were determined from a Scandinavian perspective using a 2-state Markov model with US mortality data. Subgroup and sensitivity analyses were performed. RESULTS: Over a lifetime adding rivaroxaban to aspirin had lower costs (-$3791USD/-23675DKK/-27410NOK/-29200SEK) and gained 1.17 QALYs versus ASA alone. CONCLUSION: Rivaroxaban 2.5mg twice daily with aspirin is a dominant strategy compared to aspirin alone in COMPASS participants from a Scandinavian perspective.
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Lamy et al. (2026) studied this question. Rivaroxaban plus aspirin vs. Aspirin 100mg daily was evaluated on Mean lifetime costs and quality-adjusted life-years (QALYs) (-$3791 USD and +1.17 QALYs). Adding rivaroxaban twice daily to aspirin was a dominant strategy compared to aspirin alone from a Scandinavian perspective, lowering lifetime costs by $3791 USD and gaining 1.17 QALYs.
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