Abstract

VARGAS-GONZALEZ, Juan-Camilo; COLINA MURILLO, Maryam Natali  and  FAJARDO TORRES, Jonathan Alexis. Cost-Utility analyisis for the use of new oral anticoagulants compared to vitamin K antagonists for stroke disability prevention in patients with non-valvular atrial fibrillationin Colombia. Acta Neurol Colomb. [online]. 2016, vol.32, n.4, pp.297-304. ISSN 0120-8748.  https://doi.org/10.22379/24224022111.

Summary Objectives: Our objective was to develop a cost utility analysis in Colombian patients with non-valvular atrial fibrillation (AF) contrasting the new oral anticoagulants (NOAC) with vitamin K antagonists (VKA) for the stroke outcome. Methods: We executed a cost utility analysis, through a Markov process, its outcome was estimated in Quality-adjusted life year (QALY), comparing NOAC as a group with VKA. We performed a systematic revision in search for relevant publications. We evaluated 4 outcome stroke states (no stroke, independent, dependent and dead); also, we included non-brain complications. We simulated a cohort starting at 60 years old with a temporal horizon of 24 years. At the end, we performed sensibility analysis. Results: We found 3 studies that fulfilled inclusion criteria. Cost utility analysis showed a QALY increase of 0.28 years and an incremental cost of $10´559.367 of NOAC compared with VKA, with an incremental cost-effectiveness ratio (ICER) of $38.394.817, which was within cost-per-QALY threshold. Sensitivity analysis displayed that NOAC were cost effective only with low discount rates and with temporal horizons beyond 19 years. The main variability factor was NOAC costs. Conclusions: NOAC become a cost useful alternative compared to VKA in the treatment of AF patients under our model assumptions.

Keywords : Anticoagulants; atrial fibrillation; cerebral infarction; cerebrovascular disorders; costs and cost analysis; quality-adjusted life years.

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