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Medicare beneficiary out-of-pocket spending for stroke prevention in non-valvular Atrial Fibrillation: a budget analysis
Healthcare costs today are increasingly being shifted from payers to patients, yet few providers factor patient costs into treatment decisions. Recent advancements in stroke prevention in atrial fibrillation (AF) have resulted in new treatment options where previously there were few. While the clinical benefit and cost effectiveness of these treatments are supported by a growing body of evidence, the cost impact to patients has not been explored. This analysis sought to quantify patient out-of-pocket costs for three stroke prevention strategies: warfarin, dabigatran and left atrial appendage closure (LAAC) with the Watchman Device.
Source: Value in Health - May 1, 2015 Category: Global & Universal Authors: S. Armstrong, S.L. Amorosi, G. Erickson, P. Patel, K. Stein Source Type: research

Device's potential as alternative to warfarin for stroke prevention in patients with a-fib
(The JAMA Network Journals) Vivek Y. Reddy, M.D., of the Icahn School of Medicine at Mount Sinai, New York, and colleagues examined the long-term efficacy and safety, compared to warfarin, of a device to achieve left atrial appendage closure in patients with atrial fibrillation. The study appears in the Nov. 19 issue of JAMA, a cardiovascular disease theme issue.
Source: EurekAlert! - Medicine and Health - November 16, 2014 Category: Global & Universal Source Type: news

Systematic Review and Critical Appraisal of the Statistical Methods Used in Published Studies To Indirectly Compare Novel Anticoagulants (Noacs) With Warfarin for the Prevention of Stroke in Patients With Atrial Fibrillation (Af)
The three main novel anticoagulants (NOACs) currently licensed in Europe, apixaban, dabigatran and rivaroxaban, have all been directly compared against warfarin in randomised controlled trials. However, none of the three drugs have been directly compared against each other. Thus, there has been an increase in the number of meta-analyses and indirect comparisons published comparing the relative efficacy and safety of these novel anticoagulants against each other via warfarin as a common comparator.
Source: Value in Health - November 1, 2014 Category: Global & Universal Authors: I.M. Daacke Source Type: research

Pharmacoeconomic Assessment Of Apixaban Versus Standard Of Care For The Prevention Of Stroke In Italian Non-Valvular Atrial Fibrillation Patients
The objective of this study was to evaluate the cost-effectiveness of apixaban in the prevention of thromboembolic events in patients with non-valvular atrial fibrillation (NVAF) relatively to standard of care (warfarin or aspirin) from the Italian National Health System (SSN) perspective.
Source: Value in Health - November 1, 2014 Category: Global & Universal Authors: L. Pradelli, M. Calandriello, Virgilio R. Di, M. Bellone, M Tubaro Source Type: research

Build Model with Asia Pacific Region in Mind: Modeling INR Control in a Cost-Effectiveness Model for Stroke Prevention in Atrial Fibrillation Patients
Patients, physician behaviors, and health systems differ across regions. Models without features to account for heterogeneity can’t be readily adapted in AP region. Warfarin, the standard care for stroke prevention in atrial fibrillation patients, requires routine monitoring of International Normalized Ratio (INR). Below or above the target range (2.0-3.0) increases ischemic or hemorrhagic events, respectively. Time in therapeutic range (TTR) determines therapeutic effectiveness. INR monitoring and increased hemorrhagic risk created barriers for broad effective warfarin use in AP region.
Source: Value in Health - November 1, 2014 Category: Global & Universal Authors: J. Chen, Y. Wan, F. Chen, Z.G. Lu Tags: Research on Methods - Modeling Methods Source Type: research

Relation Of The Time In Therapeutic Range (Ttr) Of Warfarin To Bleeding Incidences In Patients With Atrial Fibrillation
This study aims to compare and establish relation of time in therapeutic range (TTR) of warfarin in patients with atrial fibrillation in the first 6 months and 6 month thereafter of anticoagulation therapy.
Source: Value in Health - November 1, 2014 Category: Global & Universal Authors: M.A.S. Jasmi, M.N. Mazlan, S. Shaharuddin, H.H. Zulkifly, C.M. Long, R. Hashim, Wahab M.S. Abdul Source Type: research

Study On Drug Utilization And Assessment Of Stroke Risk Using Chads2 And Cha2ds2-Vasc Scoring In Elderly Patients With Non-Valvular Atrial Fibrillation
Stroke Risk Stratification in AF patients of can be done using CHADS2 (Congestive heart failure, Hypertension, Age ≥75, DM, prior Stroke/TIA [2 points] ); or CHA2DS2VASc2 (Congestive heart failure/left ventricular ejection fraction ≤35%, Hypertension, Age ≥75 [2 points], DM, prior Stroke/TIA/thromboembolism [2 points], Vascular disease, Age 65–74, Sex- female). Treatment options for Prevention of stroke includes Anti-coagulants (Vitamin K Antagonist-Warfarin, Acenocoumarol; and Newer Oral Anticoagulant- Dabigatran) and anti-platelets (Aspirin and Clopidogrel).
Source: Value in Health - November 1, 2014 Category: Global & Universal Authors: T. Raj, S. Bonthu, S.R. Mallayasamy Source Type: research

Discontinuation And Hospitalisation Rates In Patients With Atrial Fibrillation: Follow-Up Results Of The Prefer In Af Registry
The great majority of patients with atrial fibrillation (AF) require lifelong antithrombotic therapy for prevention of stroke. For optimal treatment, it is important to investigate treatment discontinuations, as those might be associated with increased hospitalization rates. As potential indicator for unstable anticoagulation efforts we assessed hospitalization rates for non-vitamin K antagonist oral anticoagulants (NOAC) and for warfarin under real-life practice conditions.
Source: Value in Health - November 1, 2014 Category: Global & Universal Authors: B. Brüggenjürgen, T. Schliephacke, H. Darius, R. De Caterina, J.Y. Le Heuzey, D. Pittrow, P.E. Reimitz, R.J. Schilling, J.L. Zamorano, P. Kirchhof Source Type: research

Setting up the Right Scenarios for Cost-Effectiveness Analysis: An Example with Anticoagulants for Stroke Prevention in Atrial Fibrillation Patients in China
Warfarin, the standard oral anticoagulant for stroke prevention in patients with atrial fibrillation (AF), is associated with frequent international normalized ratio (INR) monitoring and increased hemorrhagic risk. About 50% of European and American AF patients received warfarin nevertheless. Dabigatran, a novel oral anticoagulant, had been compared to warfarin to demonstrate its cost-effectiveness in developed countries. However, these economic evaluations couldn’t be applied to China setting. Despite treatment guidelines, warfarin use was conservative in China accounting for only 2.7% AF patients.
Source: Value in Health - November 1, 2014 Category: Global & Universal Authors: Y. Wan, Z.G. Lu, F. Chen, J. Chen Source Type: research

Health Care Utilization and Costs After Warfarin Discontinuation Among Patients with Non-Valvular Atrial Fibrillation
This study compared health care utilization/costs between patients with non-valvular atrial fibrillation who were persistent with warfarin therapy (WP patients) and those who discontinued warfarin therapy (WD patients) in the US usual clinical practice setting.
Source: Value in Health - November 1, 2014 Category: Global & Universal Authors: J. Wang, Y. Qiao, C.A. Spivey, X. Liu, H. Phatak, J. Mardekian, A.B. Claflin, S. Kachroo, Y. Abdulsatter, R.B. Parker Source Type: research

Initiation of Oral Anticoagulant Drugs: Identification of Drivers of Prescribing of New Agents Versus Warfarin
This study aimed to identify factors associated with anticoagulation initiation with NOACs versus warfarin.
Source: Value in Health - November 1, 2014 Category: Global & Universal Authors: S. Spillane, K. Bennett, M. Barry Source Type: research

A new era of stroke prevention in atrial fibrillation: comparing a new generation of oral anticoagulants with warfarin
Traditionally, warfarin has been used to prevent stroke in patients with atrial fibrillation (AF), but data from large, multinational, prospective, randomized studies suggest that novel oral anticoagulants (NOACs) may be suitable alternatives. These include the direct thrombin inhibitor dabigatran and the factor Xa inhibitors rivaroxaban, apixaban, and edoxaban. These data showed that dabigatran 150 mg twice daily was more effective at preventing stroke than warfarin, with similar rates of major bleeding, while rivaroxaban 20 mg once daily was noninferior to warfarin, with no difference in major bleeding rates. In addition...
Source: International Archives of Medicine - October 31, 2013 Category: Global & Universal Authors: Bruce Stambler Source Type: research

Could new anticoagulants replace Coumadin?
Anticoagulants are used by millions of people every day to lower their risk of stroke. The most common blood thinner is warfarin, also known as Coumadin. In recent years, three new anticoagulants -- Pradaxa, Eliquis and Xarelto -- are threatening Coumadin's status as the most prescribed anticoagulant. Richard Kovacs, M.D., clinical director for the Krannert Institute of Technology, stopped by "Sou....
Source: Sound Medicine - July 28, 2013 Category: Global & Universal Authors: Sound Medicine Source Type: news

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