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Cost Effectiveness of Treatments for Stroke Prevention in Atrial Fibrillation: Focus on the Novel Oral Anticoagulants

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Abstract

For more than 5 decades, the only available treatment for the prevention of atrial fibrillation (AF)-related stroke were the vitamin K antagonists. Recently, novel oral anticoagulants (NOAC) have been approved for the prevention of AF-related stroke. In the present article, the cost effectiveness of AF-related stroke-prevention strategies is reviewed. The emphasis on NOACs aims to provide an overview of their impact on health economics based on the published cost-effectiveness analyses. The available evidence suggests that the balance from the efficacy and safety point of view makes the treatment with the NOACs a cost-effective alternative to warfarin. Thus, the NOACs offer efficacy, safety and convenience, as well as cost effectiveness, for stroke prevention in AF.

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Acknowledgments

SA and CK performed the literature search and prepared the first draft. GYHL designed and supervised the analysis, interpreted the data and edited the final version of the manuscript. LE, LHR and GB provided expert opinion on the interpretation of the data and edited the final version of the manuscript. SA and CK have no conflicts of interest to declare. GB has been received speaker fees from Medtronic. LHR has been on the speakers' bureau for Bayer, BMS/Pfizer, Roche Diagnostics, and Boehringer Ingelheim. GL has received funding for research, consultancy and lecturing from different manufacturers of drugs used for the treatment of atrial fibrillation, including Bayer, Boehringer Ingelheim, BMS/Pfizer, Astellas, Medtronic, Sanofi-Aventis and Daiichi-Sankyo.

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Authors and Affiliations

  1. University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, B18 7QH, UK

    Charalampos Kasmeridis, Stavros Apostolakis & Gregory Y. H. Lip

  2. Department of Clinical Medicine, Faculties of Health Science and Social Science, Danish Center for Healthcare Improvements, University of Aalborg, Aalborg, Denmark

    Lars H. Rasmussen

  3. Institute of Cardiology, University of Bolognia, Bologna, Italy

    Giuseppe Boriani

  4. Danish Center for Healthcare Improvements (DCHI), Department of Business & Management, Faculties of Health Science and Social Science, University of Aalborg, Fibigerstraede 11, 9200, Aalborg, Denmark

    Lars Ehlers

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  1. Charalampos Kasmeridis
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Correspondence to Gregory Y. H. Lip.

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C. Kasmeridis and S. Apostolakis are joint first authors.

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Kasmeridis, C., Apostolakis, S., Ehlers, L. et al. Cost Effectiveness of Treatments for Stroke Prevention in Atrial Fibrillation: Focus on the Novel Oral Anticoagulants. PharmacoEconomics 31, 971–980 (2013). https://doi.org/10.1007/s40273-013-0090-1

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  • DOI: https://doi.org/10.1007/s40273-013-0090-1

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