title: The cost of monitoring warfarin in patients with chronic atrial fibrillation in primary care in Sweden.
abstract: BACKGROUND
  Warfarin is used for the prevention of stroke in chronic atrial fibrillation. The product has a narrow therapeutic index and to obtain treatment success, patients must be maintained within a given therapeutic range (International Normalised Ratio;INR). To ensure a wise allocation of health care resources, scrutiny of costs associated with various treatments is justified. The objective of this study was to estimate the health care cost of INR controls in patients on warfarin treatment with chronic atrial fibrillation in primary care in Sweden.
  
  
  METHODS
  Data from various sources were applied in the analysis. Resource consumption was derived from two observational studies based on electronic patient records and two Delphi-panel studies performed in two and three rounds, respectively. Unit costs were taken from official databases and primary health care centres.
  
  
  RESULTS
  The mean cost of one INR control was SEK 550. The mean costs of INR controls during the first three months, the first year and during the second year of treatment were SEK 6,811, SEK 16,244 and SEK 8,904 respectively.
  
  
  CONCLUSIONS
  INR controls of patients on warfarin treatment in primary care in Sweden represent a substantial cost to the health care provider and they are particularly costly when undertaken in home care. The cost may however be off-set by the reduced incidence of stroke.
authors.affiliation: Institute of Clinical Sciences, Göteborg University, Göteborg, Sweden and Nordic Health Economic Research AB, Göteborg, Sweden. inb@nheresearch.se
authors.forename: Ingela
authors.initials: I
authors.lastname: Björholt
authors.forename: Stina
authors.initials: S
authors.lastname: Andersson
authors.forename: Gunnar H
authors.initials: GH
authors.lastname: Nilsson
authors.forename: Ingvar
authors.initials: I
authors.lastname: Krakau
mesh_terms: D000925:Anticoagulants / Q000191:economics* / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications* / Q000453:epidemiology; D002908:Chronic Disease; D016903:Drug Monitoring / Q000191:economics*; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D019934:International Normalized Ratio / Q000191:economics / Q000706:statistics & numerical data; D015995:Prevalence; D011320:Primary Health Care / Q000191:economics; D020521:Stroke / Q000517:prevention & control*; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D014859:Warfarin / Q000191:economics* / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin