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October 20, 2015EP Europace28 citationsOpen Access

Patient-reported treatment satisfaction and budget impact with rivaroxaban vs. standard therapy in elective cardioversion of atrial fibrillation: apost hocanalysis of the X-VeRT trial

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SHStefan H. HohnloserRCRiccardo CappatoMEMichael D. Ezekowitz

Key Result

Rivaroxaban significantly improved patient-reported Global satisfaction compared to VKAs (82.07 vs. 66.74; P<0.0001) and resulted in estimated cost savings in the UK and Italy.

Structured PICO

Does rivaroxaban improve treatment satisfaction and reduce costs compared to VKAs in patients with non-valvular atrial fibrillation undergoing elective cardioversion?

P
Population
632 patients with non-valvular atrial fibrillation undergoing elective cardioversion procedures (delayed cardioversion group in the X-VeRT trial)
I
Intervention
Rivaroxaban
C
Comparator
Vitamin K antagonists (VKAs)
O
Outcome
Patient-reported treatment satisfaction (assessed using the Treatment Satisfaction Questionnaire for Medication version II) and economic impact (total costs of cardioversion)patient reported

Rivaroxaban improves patient satisfaction and reduces healthcare costs compared to VKAs in patients undergoing elective cardioversion for atrial fibrillation.

Main Result

Absolute Event Rate: 82.07% vs 66.74%

p-value: p=< 0.0001

Abstract

AIMS: We compared patient-reported treatment satisfaction and the economic impact of anticoagulation therapy with rivaroxaban vs. vitamin K antagonists (VKAs) in patients with non-valvular atrial fibrillation undergoing elective cardioversion procedures. METHODS AND RESULTS: The current study is a post hoc analysis of the prospective, multicentre X-VeRT (EXplore the efficacy and safety of once-daily oral riVaroxaban for the prevention of caRdiovascular events in subjects with non-valvular aTrial fibrillation scheduled for cardioversion) trial. Patient-reported treatment satisfaction with anticoagulation therapy was assessed using the Treatment Satisfaction Questionnaire for Medication version II in seven countries (US, UK, Canada, Germany, France, Italy, and the Netherlands). An economic model was also developed to estimate the impact of postponed cardioversions for two countries (UK and Italy). This model estimated the total costs of cardioversion, taking into consideration the costs for drug therapy (including extended treatment duration due to cardioversion postponement), international normalized ratio monitoring of VKAs, the cardioversion procedure, and rescheduling the procedure. These costs were linked to the respective X-VeRT study data to estimate the total costs. Patients receiving rivaroxaban in the delayed cardioversion group had significantly higher scores for Convenience, Effectiveness, and Global satisfaction (81.74 vs. 65.78; 39.41 vs. 32.95; and 82.07 vs. 66.74, respectively; P < 0.0001). Based on the total patient population included in the treatment satisfaction substudy (n = 632) in the delayed cardioversion group in X-VeRT, the use of rivaroxaban was estimated to result in a saving of £421 and €360 per patient in UK and Italian settings, respectively. CONCLUSION: The use of rivaroxaban in the setting of cardioversion resulted in greater patient satisfaction and cost savings, compared with that of VKA.

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Cite This Study

Hohnloser et al. (2015) studied Non-valvular atrial fibrillation undergoing elective cardioversion (n=632). Rivaroxaban vs. Vitamin K antagonists (VKAs) was evaluated on Global satisfaction score (p=< 0.0001). Rivaroxaban significantly improved patient-reported Global satisfaction compared to VKAs (82.07 vs. 66.74; P<0.0001) and resulted in estimated cost savings in the UK and Italy.

synapsesocial.com/papers/6a15867d79ff98d0de4ec280https://doi.org/10.1093/europace/euv294
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