Sökning: WFRF:(Sheng Shubin) >
Economic Analysis o...
-
Cowper, Patricia A.Duke Univ, Med Ctr, Duke Clin Res Inst, POB 17969, Durham, NC 27715 USA.
(författare)
Economic Analysis of Apixaban Therapy for Patients With Atrial Fibrillation From a US Perspective : Results From the ARISTOTLE Randomized Clinical Trial
- Artikel/kapitelEngelska2017
Förlag, utgivningsår, omfång ...
-
American Medical Association (AMA),2017
-
printrdacarrier
Nummerbeteckningar
-
LIBRIS-ID:oai:DiVA.org:uu-326359
-
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-326359URI
-
https://doi.org/10.1001/jamacardio.2017.0065DOI
Kompletterande språkuppgifter
-
Språk:engelska
-
Sammanfattning på:engelska
Ingår i deldatabas
Klassifikation
-
Ämneskategori:ref swepub-contenttype
-
Ämneskategori:art swepub-publicationtype
Anmärkningar
-
IMPORTANCE The Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial reported that apixaban therapy was superior to warfarin therapy in preventing stroke and all-cause death while causing significantly fewer major bleeds. To establish the value proposition of substituting apixiban therapy for warfarin therapy in patients with atrial fibrillation, we performed a cost-effectiveness analysis using patient-level data from the ARISTOTLE trial.OBJECTIVE To assess the cost and cost-effectiveness of apixaban therapy compared with warfarin therapy in patients with atrial fibrillation from the perspective of the US health care system.DESIGN, SETTING, AND PARTICIPANTS This economic analysis uses patient-level resource use and clinical data collected in the ARISTOTLE trial, a multinational randomized clinical trial that observed 18 201 patients (3417 US patients) for a median of 1.8 years between 2006 and 2011.INTERVENTIONS Apixaban therapy vs warfarin therapy.MAIN OUTCOMES AND MEASURES Within-trial resource use and costwere compared between treatments, using externally derived US cost weights. Life expectancies for US patients were estimated according to their baseline risk and treatment using time-based and age-based survival models developed using the overall ARISTOTLE population. Quality-of-life adjustment factors were obtained from external sources. Cost-effectiveness (incremental cost per quality-adjusted life-year gained) was evaluated from a US perspective, and extensive sensitivity analyses were performed.RESULTS Of the 3417 US patients enrolled in ARISTOTLE, the mean (SD) age was 71 (10) years; 2329 (68.2%) were male and 3264 (95.5%) were white. After 2 years of anticoagulation therapy, health care costs (excluding the study drug) of patients treated with apixaban therapy and warfarin therapy were not statistically different (difference, -$ 60; 95% CI, -$ 2728 to $ 2608). Life expectancy, modeled from ARISTOTLE outcomes, was significantly longer with apixaban therapy vs warfarin therapy (7.94 vs 7.54 quality-adjusted life years). The incremental cost, including cost of anticoagulant and monitoring, of achieving these benefits was within accepted US norms ($ 53 925 per quality-adjusted life year, with 98% likelihood of meeting a $ 100 000 willingness-to-pay threshold). Results were generally consistent when model assumptions were varied, with lifetime cost-effectiveness most affected by the price of apixaban and the time horizon.CONCLUSIONS AND RELEVANCE Apixaban therapy for ARISTOTLE-eligible patients with atrial fibrillation provides clinical benefits at an incremental cost that represents reasonable value for money judged using US benchmarks for cost-effectiveness.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
-
Sheng, ShubinDuke Univ, Med Ctr, Duke Clin Res Inst, POB 17969, Durham, NC 27715 USA.
(författare)
-
Lopes, Renato D.Duke Univ, Med Ctr, Duke Clin Res Inst, POB 17969, Durham, NC 27715 USA.
(författare)
-
Anstrom, Kevin J.Duke Univ, Med Ctr, Duke Clin Res Inst, POB 17969, Durham, NC 27715 USA.
(författare)
-
Stafford, Judith A.Duke Univ, Med Ctr, Duke Clin Res Inst, POB 17969, Durham, NC 27715 USA.
(författare)
-
Davidson-Ray, LindaDuke Univ, Med Ctr, Duke Clin Res Inst, POB 17969, Durham, NC 27715 USA.
(författare)
-
Al-Khatib, Sana M.Duke Univ, Med Ctr, Duke Clin Res Inst, POB 17969, Durham, NC 27715 USA.
(författare)
-
Ansell, JackHofstra Northwell Sch Med, Dept Med, Hemstead, NY USA.
(författare)
-
Dorian, PaulUniv Toronto, Div Cardiol, Toronto, ON, Canada.
(författare)
-
Husted, SteenAarhus Univ, Aarhus, Denmark.
(författare)
-
McMurray, John J. V.Univ Glasgow, British Heart Fdn, Cardiovasc Res Ctr, Glasgow, Lanark, Scotland.
(författare)
-
Steg, P. GabrielUniv Paris Diderot, Dept Hosp Univ Fibrosis Inflammat Remodeling, AP HP, Sorbonne Paris Cite,French Alliance Cardiovasc Cl, Paris, France.;Univ Paris Diderot, Sorbonne Paris Cite, INSERM, U 1148, Paris, France.;Imperial Coll, Royal Brompton Hosp, Natl Heart & Lung Inst, London, England.
(författare)
-
Alexander, John H.Duke Univ, Med Ctr, Duke Clin Res Inst, POB 17969, Durham, NC 27715 USA.
(författare)
-
Wallentin, Lars,1943-Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)larswall
(författare)
-
Granger, Christopher B.Duke Univ, Med Ctr, Duke Clin Res Inst, POB 17969, Durham, NC 27715 USA.
(författare)
-
Mark, Daniel B.Duke Univ, Med Ctr, Duke Clin Res Inst, POB 17969, Durham, NC 27715 USA.
(författare)
-
Duke Univ, Med Ctr, Duke Clin Res Inst, POB 17969, Durham, NC 27715 USA.Hofstra Northwell Sch Med, Dept Med, Hemstead, NY USA.
(creator_code:org_t)
Sammanhörande titlar
-
Ingår i:JAMA cardiology: American Medical Association (AMA)2:5, s. 525-5342380-65832380-6591
Internetlänk
Hitta via bibliotek
Till lärosätets databas
- Av författaren/redakt...
-
Cowper, Patricia ...
-
Sheng, Shubin
-
Lopes, Renato D.
-
Anstrom, Kevin J ...
-
Stafford, Judith ...
-
Davidson-Ray, Li ...
-
visa fler...
-
Al-Khatib, Sana ...
-
Ansell, Jack
-
Dorian, Paul
-
Husted, Steen
-
McMurray, John J ...
-
Steg, P. Gabriel
-
Alexander, John ...
-
Wallentin, Lars, ...
-
Granger, Christo ...
-
Mark, Daniel B.
-
visa färre...
- Om ämnet
-
- MEDICIN OCH HÄLSOVETENSKAP
-
MEDICIN OCH HÄLS ...
-
och Klinisk medicin
-
och Kardiologi
- Artiklar i publikationen
-
JAMA cardiology
- Av lärosätet
-
Uppsala universitet