New AF drug ‘cost-effective’
The new oral anticoagulant dabigatran could be a cost-effective alternative to warfarin for stroke prevention in patients with atrial fibrillation (AF), a study shows.
Dabigatran is easier to use than warfarin and has been shown to be at least as effective without increasing the risk of bleeding, but is more expensive than the older drug.
US researchers, led by Dr Mintu Turakhia from Stanford University in California, modeled the long-term cost-effectiveness of dabigatran relative to warfarin (dose-adjusted to a target INR of 2.0-3.0) by extrapolating clinical trial data, using UK pricing.
They report in the journal Annals of Internal Medicine, for patients aged 65 years or older with at least one risk factor for stroke, the cost would be equivalent to about £28,000 per quality-adjusted life-year gained with use of high-dose dabigatran compared with warfarin - coming in just under the £30,000 NICE cost-effectiveness threshold. The cost-effectiveness of this dose improved in patients at higher risk of stroke, whereas a lower dose of the drug was more cost-effective in patients at low risk.
Jonathan Mant, Professor of Primary Care at Cambridge University and an associate director of the Stroke Research Network, told GP News that the study "provides important information on the cost effectiveness of dabigatran relative to warfarin", and suggests that the "extra cost might be worthwhile".
Professor Mant said that "a key group to target with dabigatran in the first instance will be people at high risk of stroke who are not currently on warfarin, perhaps because of bleeding or because of poor INR control or patient preference".
GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2010
By Caroline Price