Costs and effects of long-term oral anticoagulant treatment after myocardial infarction.
OBJECTIVE
To investigate the costs and effects of long-term oral anticoagulant treatment after myocardial infarction.


METHODS
Cost-effectiveness analysis, based on a randomized, double-blind, placebo-controlled trial.


METHODS
Sixty Dutch hospitals.


METHODS
A total of 3404 hospital survivors of acute myocardial infarction randomized within a median period of 4 days after discharge to either oral anticoagulant treatment or placebo. The mean follow-up was 37 months.


METHODS
Oral anticoagulant treatment aimed at a target international normalized ratio of 2.8 to 4.8.


METHODS
Costs of hospital stay during readmissions, costs related to major cardiologic interventions, and costs of oral anticoagulant treatment.


RESULTS
The costs of oral anticoagulant treatment were estimated at 394 Dutch guilders (Dfl) per patient-year (Dfl 1 = US $0.58). Placebo patients stayed 18,830 days in the hospital compared with 15,083 days for anticoagulation patients. Average costs per patient of medical care during follow-up were estimated at Dfl 10,784 for placebo patients and Dfl 9878 for anticoagulation patients.


CONCLUSIONS
Costs of long-term anticoagulant treatment are outweighed by the costs of prevented clinical events.
van Bergen
P F
PF
ASPECT Coordinating Centre, Rotterdam, The Netherlands.
Jonker
J J
JJ
van Hout
B A
BA
van Domburg
R T
RT
Deckers
J W
JW
Azar
A J
AJ
Hofman
A
A
D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000191:economics* / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D004311:Double-Blind Method; D016527:Drug Costs / Q000706:statistics & numerical data; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000191:economics* / Q000517:prevention & control; D009426:Netherlands; D017741:Survivors
D000925:Anticoagulants