Rashki Kemmak Asma, Etemad Leila, Haghighizadeh Atoosa, Saniee Nadia, Rajabi Omid
Department of Public Health, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
Department of Pharmaceutical Control, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
Med J Islam Repub Iran. 2024 Sep 16;38:106. doi: 10.47176/mjiri.38.106. eCollection 2024.
Cardiovascular diseases (CVDs) are one of the chronic diseases and the leading cause of death worldwide. More people die from CVDs worldwide than from any other cause each year. The effects of CVDs are not limited to mortality and morbidity but also have important health and economic outcomes.
This was a systematic review that evaluated the economic evaluation of rivaroxaban plus aspirin compared with aspirin alone for the treatment of CVDs. The present study reviewed articles that performed a complete economic evaluation, including cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis related to the economic evaluation of rivaroxaban compared to enoxaparin for knee replacement patients during the years 2007 and 2023. In order to find relevant studies, databases including Pubmed, Web of Science, Embase, Scopus, Economic Evaluations Database, and Proquest were searched. Inclusion criteria included Studies that carried out a complete economic evaluation including cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis in relation to the economic evaluation of rivaroxaban plus aspirin compared to aspirin alone for CVD patients, economic evaluation studies carried out using decision analysis models based on the economic evaluation approach, full-text studies, English studies, and were studies published between 2007 and 2023. Exclusion criteria also included partial economic evaluation (such as effectiveness evaluation, cost evaluation, and quality of life evaluation), studies of low methodological quality based on the CHEERS checklist, non-English studies and all protocols, conference abstracts, and letters-to-the-editor.
After searching various databases, all retrieved articles were entered into EndNote software, and duplicates were removed. The remaining studies were reviewed independently by two relevant researchers. At this stage, preferred reporting items for systematic reviews (PRISMA) were used to retrieve the final articles. Out of 1048 studies, nine studies met the inclusion criteria. The economic evaluation studies included in the present study were conducted between 2018 and 2023. Cost-effectiveness analysis (CEA) was used in all studies.
The findings of the present study showed that rivaroxaban plus aspirin is more cost-effective than aspirin alone in the patient with CVDs, But to generalize the results to other countries of the world, more studies are needed.
心血管疾病（CVDs）是慢性疾病之一，也是全球主要的死亡原因。全球每年死于心血管疾病的人数比死于其他任何原因的人数都多。心血管疾病的影响不仅限于死亡率和发病率，还会产生重要的健康和经济后果。
这是一项系统评价，评估了利伐沙班联合阿司匹林与单用阿司匹林治疗心血管疾病的经济学评价。本研究回顾了进行完整经济学评价的文章，包括2007年至2023年期间与利伐沙班相比依诺肝素用于膝关节置换患者的经济学评价相关的成本效益分析、成本效用分析和成本效益分析。为了找到相关研究，检索了包括PubMed、科学网、Embase、Scopus、经济评价数据库和ProQuest在内的数据库。纳入标准包括对心血管疾病患者进行完整经济学评价的研究，该评价包括利伐沙班联合阿司匹林与单用阿司匹林相比的成本效益分析、成本效用分析和成本效益分析；使用基于经济学评价方法的决策分析模型进行的经济学评价研究；全文研究；英文研究；以及2007年至2023年发表的研究。排除标准还包括部分经济学评价（如有效性评价、成本评价和生活质量评价）；基于CHEERS清单的方法学质量较低的研究；非英文研究以及所有方案、会议摘要和给编辑的信。
在检索了各种数据库后，所有检索到的文章都被录入EndNote软件，并去除了重复项。其余研究由两名相关研究人员独立审查。在此阶段，使用系统评价的首选报告项目（PRISMA）来检索最终文章。在1048项研究中，有9项研究符合纳入标准。本研究纳入的经济学评价研究在2018年至2023年期间进行。所有研究均采用成本效益分析（CEA）。
本研究结果表明，在心血管疾病患者中，利伐沙班联合阿司匹林比单用阿司匹林更具成本效益，但要将结果推广到世界其他国家，还需要更多的研究。
