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Research article
Xiangli Cui
Beijing Friendship Hospital, Capital Medical University
Corresponding Author
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Background and objective: To evaluate the cost-effectiveness of new anticoagulants and warfarin in the prevention of stroke in Chinese patients with atrial fibrillation (AF).
Methods: The Markov model was constructed to compare patients’ quality-adjusted life-years (QALYs) using drug cost, the cost of the examination after taking a drug, and the incremental cost of other treatments. Both dabigatran (110 and 150 mg, twice a day) and rivaroxaban (20 mg, once a day) were compared with warfarin (3-6 mg, once a day). Willingness to pay, three times the 2018 China GDP per capita (9481.88 $), was the cost-effect threshold in our study.
Results: The total cost were was 5317.31$, 29673.33$, 23615.49$, and 34324.91$ for warfarin, rivaroxaban, dabigatran 110mg bid, and dabigatran 150mg bid, respectively. The QALYs for each of the four interventions were 11.07 years, 15.46 years, 12.4 years, and 15 years, respectively. The cost-effectiveness analysis of the three new oral anticoagulants and warfarin showed that the incremental cost-effectiveness ratio (ICER) was 5548.07$/QALY when rivaroxaban was compared with warfarin. Rivaroxaban was the most cost-effective choice and warfarin was the least.
Conclusion: In Chinese patients with AF, although warfarin is cheaper, rivaroxaban has a better cost-effectiveness advantage from an economic point of view.
Keywords
warfarin, cost-effectiveness, new oral anticoagulants, Chinese population
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Review #2 received
Received 16 Dec, 2020
Editorial decision: Minor revision
On 16 Dec, 2020
Reviewer #2 agreed
On 18 Nov, 2020
Review #1 received
Received 13 Nov, 2020
Reviewer #1 agreed
On 26 Oct, 2020
Reviewers invited
Invitations sent on 22 Oct, 2020
Editor assigned
On 13 Oct, 2020
Submission checks complete
On 12 Oct, 2020
Editor invited
On 12 Oct, 2020
No comments provided
Editorial decision: Major revision
On 23 Sep, 2020
Review #2 received
Received 15 Sep, 2020
Reviewer #2 agreed
On 31 Jul, 2020
Review #1 received
Received 21 Jul, 2020
Reviewer #1 agreed
On 26 Jun, 2020
Reviewers invited
Invitations sent on 18 May, 2020
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On 28 Apr, 2020
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See the published version of this preprint at BMC Health Services Research.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Xiangli Cui
Beijing Friendship Hospital, Capital Medical University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Health Services Research.
Version 3
Posted 19 Jan, 2021
No community comments so far
Submission checks complete
On 12 Jan, 2021
Editorial decision: Accept
On 11 Jan, 2021
Version (no preprint)
Posted 05 Jan, 2021
Editor assigned
On 05 Jan, 2021
Submission checks complete
On 05 Jan, 2021
Editor invited
On 05 Jan, 2021
This version was not preprinted
Version (no preprint)
Posted 27 Dec, 2020
Editor assigned
On 27 Dec, 2020
Submission checks complete
On 27 Dec, 2020
Editor invited
On 27 Dec, 2020
This version was not preprinted
No comments provided
Review #2 received
Received 16 Dec, 2020
Editorial decision: Minor revision
On 16 Dec, 2020
Reviewer #2 agreed
On 18 Nov, 2020
Review #1 received
Received 13 Nov, 2020
Reviewer #1 agreed
On 26 Oct, 2020
Reviewers invited
Invitations sent on 22 Oct, 2020
Editor assigned
On 13 Oct, 2020
Submission checks complete
On 12 Oct, 2020
Editor invited
On 12 Oct, 2020
No comments provided
Editorial decision: Major revision
On 23 Sep, 2020
Review #2 received
Received 15 Sep, 2020
Reviewer #2 agreed
On 31 Jul, 2020
Review #1 received
Received 21 Jul, 2020
Reviewer #1 agreed
On 26 Jun, 2020
Reviewers invited
Invitations sent on 18 May, 2020
Editor assigned
On 28 Apr, 2020
Submission checks complete
On 27 Apr, 2020
Editor invited
On 27 Apr, 2020
First submitted
On 25 Apr, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Health Services Research.
Background and objective: To evaluate the cost-effectiveness of new anticoagulants and warfarin in the prevention of stroke in Chinese patients with atrial fibrillation (AF).
Methods: The Markov model was constructed to compare patients’ quality-adjusted life-years (QALYs) using drug cost, the cost of the examination after taking a drug, and the incremental cost of other treatments. Both dabigatran (110 and 150 mg, twice a day) and rivaroxaban (20 mg, once a day) were compared with warfarin (3-6 mg, once a day). Willingness to pay, three times the 2018 China GDP per capita (9481.88 $), was the cost-effect threshold in our study.
Results: The total cost were was 5317.31$, 29673.33$, 23615.49$, and 34324.91$ for warfarin, rivaroxaban, dabigatran 110mg bid, and dabigatran 150mg bid, respectively. The QALYs for each of the four interventions were 11.07 years, 15.46 years, 12.4 years, and 15 years, respectively. The cost-effectiveness analysis of the three new oral anticoagulants and warfarin showed that the incremental cost-effectiveness ratio (ICER) was 5548.07$/QALY when rivaroxaban was compared with warfarin. Rivaroxaban was the most cost-effective choice and warfarin was the least.
Conclusion: In Chinese patients with AF, although warfarin is cheaper, rivaroxaban has a better cost-effectiveness advantage from an economic point of view.
Figure 1
Figure 2
Figure 3
Figure 4
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