Cost-effectiveness analysis of anticoagulation options for non-valvular atrial fibrillation in Iran
Year: 2024
Type: article
Abstract: BACKGROUND: Atrial fibrillation (AF) imposes a substantial economic and clinical burden, particularly in developing countries like Iran. This study aimed to evaluate the cost-effectiveness of anticoagulation options for non-valvular atrial fibrillation (NVAF) in Iran. METHODS: We conducted a cost-effectiveness analysis comparing warfarin, apixaban, dabigatran 110 mg, dabigatran 150 mg, and rivaroxaban for NVAF patients from the Iranian payer's perspective. A Markov model with a lifetime horizon was used to estimate costs and quality-adjusted life years (QALYs). The model incorporated clinical event rates, case-fatality rates, and utility values. Uncertainty was assessed using deterministic sensitivity analysis and probabilistic sensitivity analysis. RESULTS: Among the interventions, warfarin had the lowest cost ($1,755) but apixaban resulted in the highest QALYs (7.33). Apixaban was the most cost-effective strategy with an incremental cost-effectiveness ratio (ICER) of $2,026 per QALY gained compared to warfarin. Apixaban dominated other treatments, with lower costs and higher QALYs. Probabilistic sensitivity analysis indicated that at Iran's willingness-to-pay threshold of $4,387 per QALY gained, apixaban had a high probability of being cost-effective (88.2%). CONCLUSION: Our study provides strong evidence for healthcare decision-makers in Iran, showing that apixaban is a cost-effective treatment for NVAF, potentially enhancing patient outcomes and optimizing healthcare expenditures.
Source: BMC Research Notes
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,790
OpenAlex ID: W4404719977