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Use of real-world evidence in meta-analyses and cost-effectiveness models.
The objectives of this communication were to (1) summarise all guidance on how to conduct an RWE meta-analysis (MA) and how to develop an RWE cost-effectiveness model, (2) to describe our experience, challenges faced and solutions identified, (3) to provide recommendations on how to conduct such analyses.No formal guidelines on how to conduct an RWE MA or to develop an RWE cost-effectiveness model were identified. Using the context of non-vitamin K antagonist oral anticoagulants (NOACs) in stroke prevention in atrial fibrillation, we conducted an RWE MA, after having identified sources of uncertainty. We then implemented t...
Source: Journal of Medical Economics - July 14, 2020 Category: Health Management Tags: J Med Econ Source Type: research

Number needed to treat based on real-world evidence for non-vitamin K antagonist oral anticoagulants versus vitamin K antagonist oral anticoagulants in stroke prevention in patients with non-valvular atrial fibrillation.
CONCLUSIONS: The NNT calculation, when approached and interpreted properly, is a practical measure of the effectiveness of a treatment. The calculation based on HRs showed that NOACs are safe and effective alternatives to VKAs in real life. PMID: 30969801 [PubMed - as supplied by publisher]
Source: Journal of Medical Economics - April 12, 2019 Category: Health Management Tags: J Med Econ Source Type: research

Healthcare costs of stroke and major bleeding in patients with atrial fibrillation treated with non-vitamin K antagonist oral anticoagulants.
CONCLUSIONS: The incremental healthcare costs incurred by patients with versus without stroke/SE was nearly twice as high as those of patients with versus without MB. Moreover, each additional year up to 4 years after the first event was associated with an incremental cost for patients with a stroke/SE or MB event compared to those without an event. PMID: 30939954 [PubMed - as supplied by publisher]
Source: Journal of Medical Economics - April 5, 2019 Category: Health Management Tags: J Med Econ Source Type: research

Rivaroxaban for non-valvular atrial fibrillation and venous thromboembolism in the Netherlands: a real-world data based cost-effectiveness analysis.
CONCLUSIONS: In patients with NVAF or VTE, rivaroxaban treatment is likely to be cost-effective and potentially cost-saving alternative to VKA in the Netherlands. PMID: 30614320 [PubMed - as supplied by publisher]
Source: Journal of Medical Economics - January 8, 2019 Category: Health Management Tags: J Med Econ Source Type: research

Annual costs attributed to atrial fibrillation management: cross-sectional study of primary healthcare electronic records
This study aims to describe overall annual costs per patient for management of non-valvular AF in a primary healthcare (PHC) setting and compare these costs between the groups of patients treated with vitamin K antagonists, antiplatelets or non-treated through a population-based study conducted with electronic health records. We analysed annual costs per person of 19,787 patients in 2012; PHC visits, hospital admissions, AF-related events requiring hospital admission, referrals to secondary specialists, sick leave, diagnostic tests and laboratory tests at PHC level, including INR determinations performed in PHC, and drug t...
Source: The European Journal of Health Economics - February 20, 2018 Category: Health Management Source Type: research

Vitamin C supplementation for the primary prevention of cardiovascular disease.
CONCLUSIONS: Currently, there is no evidence to suggest that vitamin C supplementation reduces the risk of CVD in healthy participants and those at increased risk of CVD, but current evidence is limited to one trial of middle-aged and older male physicians from the USA. There is limited low- and very low-quality evidence currently on the effect of vitamin C supplementation and risk of CVD risk factors. PMID: 28301692 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - March 15, 2017 Category: Journals (General) Authors: Al-Khudairy L, Flowers N, Wheelhouse R, Ghannam O, Hartley L, Stranges S, Rees K Tags: Cochrane Database Syst Rev Source Type: research

The cost of warfarin treatment for stroke prevention in patients with nonvalvular atrial fibrillation in Russia from a collective perspective.
CONCLUSION: Although VKA drugs costs are relatively low, regular INR testing and consultations drive the economic burden for Russian NVAF patients treated with VKA. PMID: 28151036 [PubMed - as supplied by publisher]
Source: Journal of Medical Economics - February 4, 2017 Category: Health Management Tags: J Med Econ Source Type: research

Stroke and death in elderly patients with atrial fibrillation in Japan compared with the United Kingdom
Conclusions Elderly (age ≥75 years) patients with AF in both Japan and the UK are at similarly high risk of stroke and death, with OAC still underused in both populations. Ethnicity was not independently associated with the risk of stroke, regardless of OAC use or non-use.
Source: Heart - November 10, 2016 Category: Cardiology Authors: Senoo, K., An, Y., Ogawa, H., Lane, D. A., Wolff, A., Shantsila, E., Akao, M., Lip, G. Y. H. Tags: Drugs: cardiovascular system, Heart failure, Hypertension, Epidemiology, Diabetes, Metabolic disorders Health care delivery, economics and global health care Source Type: research

Clinical and Cost Effectiveness of Apixaban Compared to Aspirin in Patients with Atrial Fibrillation: An Australian Perspective
ConclusionCompared to aspirin, apixaban is likely to be cost effective in preventing thromboembolic disease among VKA unsuitable patients with atrial fibrillation.
Source: Applied Health Economics and Health Policy - October 3, 2016 Category: Health Management Source Type: research

Clinical and economic impact of rivaroxaban on the burden of atrial fibrillation: the case study of Japan.
CONCLUSIONS: Introducing rivaroxaban may decrease the burden of NVAF in Japanese society. From a clinical perspective, the reduction in IS and embolic events outweighs the increased risk of anticoagulant-related bleeding; from an economic perspective, reduced event costs offset drug and physician visit costs, resulting in cost savings. PMID: 27112188 [PubMed - as supplied by publisher]
Source: Journal of Medical Economics - April 27, 2016 Category: Health Management Tags: J Med Econ Source Type: research

Estimation of the cost-effectiveness of apixaban versus vitamin K antagonists in the management of atrial fibrillation in Argentina
Abstract Apixaban, a novel oral anticoagulant which has been approved for the prevention of stroke and systemic embolism in non-valvular atrial fibrillation, reduces both ischemic and haemorrhagic stroke and produces fewer bleedings than vitamin K antagonist warfarin. These clinical results lead to a decrease in health care resource utilization and, therefore, have a positive impact on health economics of atrial fibrillation. The cost-effectiveness of apixaban has been assessed in a variety of clinical settings and countries. However, data from emergent markets, as is the case of Argentina, are still scarce. ...
Source: Health Economics Review - June 26, 2015 Category: Global & Universal Source Type: research

A Health Economic Evaluation of Stroke Prevention in Atrial Fibrillation: Guideline Adherence Versus the Observed Treatment Strategy Prior to 2012 in Denmark
Conclusions Guideline adherence is a cost-effective treatment strategy compared with the strategy employed prior to 2012 for pharmacological stroke prophylaxis in AF.
Source: PharmacoEconomics - May 6, 2015 Category: Health Management Source Type: research