Cost Effectiveness of Warfarin Versus Aspirin in Patients Older Than 75 Years With Atrial Fibrillation
Posted on Mon, Apr 25, 2011
Stroke, 04/25/2011 Clinical Article
Jowett S et al. – Warfarin is cost–effective compared with aspirin in atrial fibrillation patients age ≥75 years. These data support the anticoagulant therapy option in this high–risk patient population. However, the small differences in costs and effects indicate the importance of exploring patient preferences.
Methods
- An economic evaluation was conducted alongside a randomized, controlled trial; 973 patients ≥75 years of age with atrial fibrillation were recruited from primary care and randomly assigned to either take warfarin or aspirin.
- Follow-up was for a mean of 2.7 years. Costs of thrombotic and hemorrhagic events, anticoagulation clinic visits, and primary care utilization were determined.
- Clinical benefits were expressed in terms of a primary event avoided: fatal/nonfatal disabling stroke, intracranial hemorrhage, or systemic embolism.
- A cost-utility analysis was performed using quality-adjusted life years as the benefit measure.