<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0120-8748</journal-id>
<journal-title><![CDATA[Acta Neurológica Colombiana]]></journal-title>
<abbrev-journal-title><![CDATA[Acta Neurol Colomb.]]></abbrev-journal-title>
<issn>0120-8748</issn>
<publisher>
<publisher-name><![CDATA[Asociación Colombiana de Neurología]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0120-87482018000300169</article-id>
<article-id pub-id-type="doi">10.22379/24224022208</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Impacto presupuestal de dabigatrán en comparación con apixabán, rivaroxabán y warfarina para el tratamiento de fibrilación auricular no valvular en Colombia]]></article-title>
<article-title xml:lang="en"><![CDATA[Budget impact of dabigatran compared to apixaban, rivaroxaban and warfarin for the treatment of non-valvular atrial fibrillation in Colombia]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lasalvia]]></surname>
<given-names><![CDATA[Pieralessandro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernández]]></surname>
<given-names><![CDATA[Fabián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castañeda-Cardona]]></surname>
<given-names><![CDATA[Camilo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Neuro Economix  ]]></institution>
<addr-line><![CDATA[Bogotá D.C]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Pontificia Universidad Javeriana  ]]></institution>
<addr-line><![CDATA[Bogotá ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2018</year>
</pub-date>
<volume>34</volume>
<numero>3</numero>
<fpage>169</fpage>
<lpage>174</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0120-87482018000300169&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0120-87482018000300169&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0120-87482018000300169&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  INTRODUCCIÓN: La fibrilación auricular es la arritmia cardiaca más frecuente; su prevalencia aumenta con la edad y está asociada con un incremento en el riesgo de presentar accidentes cerebrovasculares e infarto agudo de miocardio. Los anticoagulantes son las alternativas de elección en la prevención de complicaciones tromboembólicas y disminución del riesgo de infarto en pacientes con fibrilación auricular no valvular (FANV). El uso de nuevos anticoagulantes orales como dabigatrán, rivaroxabán y apixabán ha aumentado debido a las diferencias en seguridad y facilidad de administración en comparación con los antagonistas de vitamina K.  MÉTODOS: Se realizó un análisis presupuestal desde la perspectiva del tercero pagador, comparando dabigatrán, apixabán, rivaroxabán y warfarina en pacientes con FANV con indicación de anticoagulación. Se consideraron dos escenarios: el primero tenía una reducción relativa de uso de dabigatrán, comparado con apixabán y riva-roxabán; el segundo tenía un incremento de dabigatrán. En ambos, el uso de warfarina se mantenía estable.  RESULTADOS: El escenario de disminución de uso de dabigatrán mostró aumento de presupuesto de $1.925.441.674 en el segundo año y $3.670.041.761 en el tercero. El escenario de aumento de uso de dabiga-trán mostró reducción global de costos de -$1.498.527.642 en el segundo año y -$2.119.252.605 en el tercero.  CONCLUSIONES: Esta evaluación de impacto presupuestal mostró que el incremento en el uso de dabigatrán a lo largo del horizonte temporal de tres años representa un ahorro de hasta $2.119.252.605 en el tratamiento anticoagulante de FANV en Colombia. De acuerdo con el modelo utilizado en el presente estudio, es posible afirmar que la inclusión de dabigatrán en el presupuesto sanitario del sistema de salud colombiano para el tratamiento de FANV es económicamente viable, además de ser una opción que genera ahorro en el mediano plazo.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[SUMMARY  BACKGROUND: Atrial fibrillation is the most frequent cardiac arrhythmia; prevalence increases with age and is associated with an increase in the risk of stroke and acute myocardial infarction. Anticoagulants are the treatment of choice to prevent thromboembolic complications and reduce infarction risk in patients with non-valvular atrial fibrillation (NVAF). The utilization of new oral anticoagulants such as dabigatran, rivaroxaban and apixaban has increased, due to the safety profile of vitamin K antagonists.  METHODOLOGY: A budget impact analysis comparing dabigatran, rivaroxaban, apixaban and warfarin in patients with NVAF was carried out from the third payer's perspective. Two scenarios were considered: In the first one, there is a relative decrease on dabigatran utilization compared with apixaban and rivaroxaban. In the other one, dabigatran utilization increased. In both scenarios, warfarin utilization remained constant.  RESULTS: In the scenario in which dabigatran utilization decreased, there was a budget increase of $1,925,441,674 in the second year, and $3,670,041,761 in the third. In the increase of dabigatran utilization scenario, we find a global cost reduction of -$1,498,527,642 in the second year and -$2,119,252,605 in the third.  CONCLUSIONS: Increase of dabigatran utilization throughout the time horizon is a cost saving decision on anticoagulant treatment of NVAF.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Fibrilación atrial]]></kwd>
<kwd lng="es"><![CDATA[Dabigatran]]></kwd>
<kwd lng="es"><![CDATA[Apixaban]]></kwd>
<kwd lng="es"><![CDATA[Rivaroxaban,Costos y Análisis de Costo (DeCS)]]></kwd>
<kwd lng="en"><![CDATA[Atrial Fibrillation]]></kwd>
<kwd lng="en"><![CDATA[Dabigatran]]></kwd>
<kwd lng="en"><![CDATA[Apixaban]]></kwd>
<kwd lng="en"><![CDATA[Rivaroxaban]]></kwd>
<kwd lng="en"><![CDATA[Costs and Cost Analysis (MeSH)]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Xu]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Luc]]></surname>
<given-names><![CDATA[JGY]]></given-names>
</name>
<name>
<surname><![CDATA[Phan]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Atrial fibrillation: review of current treatment strategies]]></article-title>
<source><![CDATA[J Thorac Dis]]></source>
<year>2016</year>
<volume>8</volume>
<page-range>E886-900</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Copley]]></surname>
<given-names><![CDATA[DJ]]></given-names>
</name>
<name>
<surname><![CDATA[Hill]]></surname>
<given-names><![CDATA[KM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Atrial fibrillation: A review of treatments and current guidelines]]></article-title>
<source><![CDATA[AACN Adv Crit Care]]></source>
<year>2016</year>
<volume>27</volume>
<page-range>120-8</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rosselli]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
<name>
<surname><![CDATA[García]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
<name>
<surname><![CDATA[Rueda]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalencia de fibrilación auricular en un hospital universitario colombiano]]></article-title>
<source><![CDATA[Rev Colomb Cardiol]]></source>
<year>2013</year>
<volume>20</volume>
<page-range>383-5</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="">
<collab>Departamento Administrativo Nacional de Estadística (DANE)</collab>
<source><![CDATA[Población, Edades Simples, 1985-2020. Proyecciones de Población]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kirchhof]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Benussi]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Kotecha]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Ahlsson]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Atar]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Casadei]]></surname>
<given-names><![CDATA[&#914;]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS]]></article-title>
<source><![CDATA[Eur J Cardiothorac Surg]]></source>
<year>2016</year>
<volume>50</volume>
<page-range>e1-88</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<collab>European Heart Rhythm Association</collab>
<collab>European Association for Cardio-Thoracic Surgery</collab>
<article-title xml:lang=""><![CDATA[Guidelines for the management of atrial fibrillation: the task force for the management of atrial fibrillation of the European Society of Cardiology (ESC)]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Camm]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
<name>
<surname><![CDATA[Kirchhof]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Lip]]></surname>
<given-names><![CDATA[GYH]]></given-names>
</name>
<name>
<surname><![CDATA[Schotten]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
</person-group>
<source><![CDATA[Europace]]></source>
<year>2010</year>
<volume>12</volume>
<page-range>1360-420</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Aristizábal]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Uribe]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Medina]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Velásquez]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
<name>
<surname><![CDATA[Marén]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
<name>
<surname><![CDATA[Duque]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Atrial fibrillation: a current view]]></article-title>
<source><![CDATA[Rev Colomb Cardiol]]></source>
<year>2012</year>
<volume>19</volume>
<page-range>235-51</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hart]]></surname>
<given-names><![CDATA[RG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Meta-analysis: Antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation]]></article-title>
<source><![CDATA[Ann Intern Med]]></source>
<year>2007</year>
<volume>146</volume>
<page-range>857-67</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mangiafico]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[Mangiafico]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Emerging anticoagulant therapies for atrial fibrillation: new options, new challenges]]></article-title>
<source><![CDATA[Curr Med Chem]]></source>
<year>2012</year>
<volume>19</volume>
<numero>27</numero>
<issue>27</issue>
<page-range>4688-98</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ganetsky]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Babu]]></surname>
<given-names><![CDATA[KM]]></given-names>
</name>
<name>
<surname><![CDATA[Salhanick]]></surname>
<given-names><![CDATA[SD]]></given-names>
</name>
<name>
<surname><![CDATA[Brown]]></surname>
<given-names><![CDATA[RS]]></given-names>
</name>
<name>
<surname><![CDATA[Boyer]]></surname>
<given-names><![CDATA[EW]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Dabigatran: Review of pharmacology and management of bleeding complications of this novel oral anticoagulant]]></article-title>
<source><![CDATA[J Med Toxicol]]></source>
<year>2011</year>
<volume>7</volume>
<page-range>281-7</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Martínez-Rubio]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Dan]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
<name>
<surname><![CDATA[Kaski]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Rivaroxaban and stroke prevention in patients with atrial fibrillation: new evidence]]></article-title>
<source><![CDATA[Expert Rev Cardiovasc Ther]]></source>
<year>2014</year>
<volume>12</volume>
<page-range>933-47</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cubillos]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Haddad]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Kuznik]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Mould-Quevedo]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Burden of disease from atrial fibrillation in adults from seven countries in Latin America]]></article-title>
<source><![CDATA[Int J Gen Med]]></source>
<year>2014</year>
<volume>7</volume>
<page-range>441-8</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mora-Llabata]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Dubois-Marqués]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Roldán-Torres]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Mateu-Navarro]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Sanz-García]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
<name>
<surname><![CDATA[Moreno-Ballester]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalencia de fibrilación auricular y características de la fibrilación auricular no valvular en la población general. Registro AFINVA]]></article-title>
<source><![CDATA[Rev Colomb Cardiol]]></source>
<year>2017</year>
<volume>24</volume>
<page-range>26-33</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Triana]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
<name>
<surname><![CDATA[Castañeda]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Parada]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Otálora-Esteban]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Rosselli]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Costo-efectividad de dabigatrán comparado con warfarina para el tratamiento de pacientes con fibrilación auricular no valvular]]></article-title>
<source><![CDATA[Rev Colomb Cardiol]]></source>
<year>2016</year>
<volume>23</volume>
<page-range>82-6</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rosselli]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Castaño]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Arciniegas]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[García]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Muñoz]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Gómez-Restrepo]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Costo-efectividad de las estatinas para el tratamiento de dislipidemia en Colombia]]></article-title>
<source><![CDATA[Acta Med Colomb]]></source>
<year>2015</year>
<volume>40</volume>
<page-range>118-24</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kodani]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Atarashi]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Inoue]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Okumura]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Yamashita]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Origasa]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Secondary prevention of stroke "with warfarin in patients with nonvalvular atrial fibrillation: Subanalysis of the J-RHYTHM registry]]></article-title>
<source><![CDATA[J Stroke Cerebrovasc Dis]]></source>
<year>2016</year>
<volume>25</volume>
<page-range>585-99</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tawfik]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Bielecki]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Krahn]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Dorian]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Hoch]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Boon]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Systematic review and network meta-analysis of stroke prevention treatments in patients with atrial fibrillation]]></article-title>
<source><![CDATA[Clin Pharmacol]]></source>
<year>2016</year>
<volume>8</volume>
<page-range>93-107</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
