February 8, 2023

Hello everyone this is michael abraham i’m today representing the clinical trial of cost effectiveness of abexe band the bigitran rivaroxaban and warframe forest stroke preventure and an atrial fibrillation patient so uh the background and purpose of this study was a cost effective of stroke prevention and non-vulva afib patients by using a new oral anticoagulant

Abixiban 5 milligram dabigitran 150 milligram aeroxiban 20 milligram compared with warfarin as a the stroke is a substantial financial burden and high uh health care system patient family and society ischemic stroke in non-verbal affection average about five percent per year which is two to seven times a rate of choose people without that condition so the methods

Of this study it we used a merkov decision analysis model using data from clinical trials to evaluate lifetime cost and cola of this kind of medication compared with warfarin the modeled population was a hypothetical cohort of 17 years old patient with non-vulvar afib increased risk for its stroke chats to more than or equal one renal clearance was more than

50 or equal to 50 milliliter per minute and no previous contraindication to anticoagulant if we move to the limitation so this trial limited to patient more uh over seven years old with nan valver afib chad’s two score equal to or more than one original curating clearance equal or more than 50 milliliter per minute and no previous container indication to enter

Q i blend further analysis needed for other population sections like the people less than 70 or have kind of um problems kidneys and creatine clearance or chats to score less less than one or any kind of population not covered by this trial there are differences among trial design outcome definitions and patient population which lead to different outcomes

And challenges at trial third renal life real life practice may lead to different outcomes due to different dosing regimen compliance and monitoring comorbidities and inclusion exclusion criteria for sure the resources were used to collect values for coast utility and other adverse events such as stroke disability after a stroke introduce bias into the anal

Analysis as the last limitation we have if we are going to move on to the results section in base case a big span five milligram cola was the highest of the anticoagulants by 8.47 whereas warfarin has the lowest quality estimate of seven point nine seven so apexiband five milligram provided an additional 0.5 collis at a cost of seven thousand five hundred

Thirteen dollars resulting in answer of fifteen thousand twenty six dollars berkeley again uh below willing to base threshold one-way sensitivity analysis conducted for cost utilities probabilities age and discount rate did not substantially influence the icer values of the new oral anticoagulant drugs compared with warframe from base case nor did zava zava

Values exceed fifty thousand beer cola that’s a threshold so in conclusions uh new oral anticoagulants are more cost effective compared with warfarin treatment for stroke prevention ambition with new vulva atrial fibrillation of the three new oral anticoagulant drugs a big seban 5 milligram was a preferred anticoagulant because it was a cost effective treatment

Option at all willing to base threshold which is more than 40 000 vertically however further analysis needed to evaluate of the cost effectiveness of uh new oral anticoagulant uh drugs and it’s in history of chat source scores and hemorrhagic risk score renal impairment and age less than 70 likes uh the sectors not covered by this trial need more studies to get

If that’s gonna be cost effective for taking uh using a big seban over warfarin healthcare providers already i’ll encounter choices between new oral anticoagulant drugs and warfarin in clinical practice for this high risk population thank you for attendance and anusha good evening take care

Transcribed from video
Cost effectiveness of Apixaban by Harrington et Al. Presentation By Michael Ibrahim