Department of Elderly Medicine, Rotherham General Hospital, Moorgate Road, Rotherham S60 2UD, UK.
Age Ageing. 2012 Sep;41(5):681-4. doi: 10.1093/ageing/afs017. Epub 2012 Feb 28.
cost of anticoagulation with dabigatran is largely based on estimation of complication rates derived from clinical trials.
to investigate cost of anticoagulation with dabigatran in comparison with warfarin in clinical practice.
a prospective observational study of patients with non-vavular atrial fibrillation (NVAF) referred to anticoagulation clinic. Patients were interviewed (4-6 weekly by telephone) about bleeding events. Costs of anticoagulation were calculated as: (i) drug cost, (ii) international normalised ratio (INR) monitoring cost and (iii) bleeding cost. For cost calculation of dabigatran, INR monitoring cost was omitted.
a total of 402 patients were included and followed up for a mean (SD) of 19 (8.1) months. Annual cost of anticoagulation was £207.3 and £1,573.5 per patient for warfarin and dabigatran, respectively. Drug price constituted 13.6% of the total cost for warfarin and 94% for dabigatran. Total cost of anticoagulation to prevent one stroke per year was £6,219, £28,086.5 and £25,181 for warfarin, dabigatran 110 and 150 mg, respectively.
cost of anticoagulation is mainly driven by drug price for dabigatran and quality of INR control for warfarin. Until the price of dabigatran is reviewed, warfarin remains suitable for the majority of patients with NVAF.
达比加群的抗凝成本主要基于临床试验中并发症发生率的估算。
研究达比加群抗凝的成本，与华法林在临床实践中的成本进行比较。
对非瓣膜性心房颤动（NVAF）患者进行前瞻性观察性研究，将这些患者转诊至抗凝门诊。通过电话（每 4-6 周一次）对患者进行访谈，了解出血事件的发生情况。抗凝成本的计算方法如下：（i）药物成本，（ii）国际标准化比值（INR）监测成本，（iii）出血成本。在达比加群的成本计算中，省略了 INR 监测成本。
共纳入 402 例患者，平均（标准差）随访 19（8.1）个月。华法林和达比加群的抗凝年费用分别为每位患者 207.3 英镑和 1573.5 英镑。药物价格占华法林总成本的 13.6%，占达比加群总成本的 94%。每年预防一次中风的抗凝总成本分别为华法林 6219 英镑、达比加群 110 毫克和 150 毫克 28086.5 英镑和 25181 英镑。
抗凝成本主要由达比加群的药物价格和华法林的 INR 控制质量驱动。在达比加群的价格得到审查之前，华法林仍然适合大多数 NVAF 患者。
