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Clinical Articles, Lead Article

‘True’ costs of NOACs assessed

Health economic studies are now assessing the true costs of non-vitamin K antagonist oral anticoagulants (NOACs) compared to warfarin. One study presented at the congress by Dr Elizabeth A Magnuson (Saint Luke’s Mid-America Heart Institute, Kansas City, USA) showed that compared with warfarin, edoxaban 60 mg (30 mg dose-reduced) once daily significantly reduced the overall rate of cardiovascular complications and bleeding-related hospitalisations and associated hospitalisation costs. 1

The investigators looked at 14,024 patients in the ENGAGE AF-TIMI 48 study and compared hospitalization rates. Rates (per 100 patient-years) of cardiovascular-related admissions, including haemorrhagic and ischaemic stroke, were lower with edoxaban (60/30 mg) than warfarin (12.8 vs. 13.9; p<0.0001). Rates of total non-stroke bleeding-related admissions were also lower with edoxaban (60/30 mg)  (2.38 vs. 2.45; p<0.0001), due to fewer subdural/epidural haematomas (0.10 vs. 0.23; p<0.0001) and extracranial bleeding complications (1.08 vs. 1.14; p<0.0001). Overall, total cardiovascular bleeding hospitalisation costs were US$147/patient-year less with edoxaban (60/30 mg) compared to warfarin (p=0.0004).

This “may to some extent offset increased drug treatment costs associated with edoxaban versus warfarin,”  said Dr Magnuson.


1. Magnuson E at al. Hospitalization-related costs among patients with atrial fibrillation treated with the factor Xa inhibitor edoxaban vs warfarin: results from the ENGAGE AF-TIMI 48 trial. Abstract P4970. Eur Heart J 2016;37(Abstract supplement):1007.

Published on: October 19, 2016

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association

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