Mitrovic Darko, Plomp Marlies, Folkeringa Richard, Veeger Nic, Feenstra Talitha, van Roon Eric
Department of Hospital Pharmacy, Tjongerschans, Heerenveen, Netherlands.
Department of Cardiology, Medical Centre Leeuwarden, Leeuwarden, Netherlands.
Curr Med Res Opin. 2021 Sep;37(9):1461-1466. doi: 10.1080/03007995.2021.1929893. Epub 2021 Jun 4.
A very common side effect of non-vitamin K antagonist oral anticoagulant (NOAC) is (minor) bleeding. Data about impact and costs of minor bleeds in NOAC therapy is still limited or not present in current literature. In this patient orientated study, we aim to provide an estimate of the costs of minor bleeds in patients with atrial fibrillation (AF) treated with a NOAC.
A retrospective observational cohort study was conducted. Patients with AF and on NOAC therapy were included. Data was obtained by questionnaires and information from electronic patient records. Reference prices were used to calculate the costs per patient. Furthermore, cost of minor bleeds per patient is compared with literature-based costs of minor and major bleeding.
139 patients were included. A total of 94 minor bleed were reported by 71 patients. The sum of minor bleeding costs from societal perspective were €9,851.49, or on average €70,87 (95% CI €54,37- €85,68) per patient with AF. The biggest cost drivers were rectal and vaginal bleeds, epistaxis was most commonly reported.
Total costs of minor bleeds from a societal perspective, in AF patients using NOACs, are non-trivial and exceed the costs presented in existing literature.
非维生素K拮抗剂口服抗凝药（NOAC）非常常见的副作用是（轻微）出血。目前文献中关于NOAC治疗中轻微出血的影响和成本的数据仍然有限或不存在。在这项以患者为导向的研究中，我们旨在估算接受NOAC治疗的房颤（AF）患者轻微出血的成本。
进行了一项回顾性观察队列研究。纳入接受NOAC治疗的AF患者。通过问卷调查和电子病历信息获取数据。使用参考价格计算每位患者的成本。此外，将每位患者轻微出血的成本与基于文献的轻微和严重出血成本进行比较。
纳入139例患者。71例患者共报告94次轻微出血。从社会角度看，轻微出血成本总计9851.49欧元，每位AF患者平均70.87欧元（95%可信区间54.37 - 85.68欧元）。最大的成本驱动因素是直肠和阴道出血，鼻出血报告最为常见。
从社会角度看，使用NOAC的AF患者轻微出血的总成本不容小觑，超过了现有文献中的成本。
