title: Stop the clots, but at what cost? Pharmacoeconomics of dabigatran etexilate for the prevention of stroke in subjects with atrial fibrillation: a systematic literature review.
abstract: Dabigatran etexilate is a newly approved agent for prophylaxis of stroke in atrial fibrillation. Through narrative review, the authors assess evidence of the efficacy of dabigatran in stroke prevention, focusing on the multicenter, randomized trial RE-LY. The authors complement this with a review of the clinical efficacy of standard treatments (antiplatelet and warfarin). Finally, the authors present a systematic review of published studies describing the economics of dabigatran. Our systematic search gave six economic reviews from a variety of healthcare systems (the USA, Canada and the UK) and utilizing different economic models. Analyses suggest economic benefit of high- or sequential-dose dabigatran, particularly when stroke risk is high; intracerebral hemorrhage risk is high or warfarin control is poor. However, questions remain around dabigatran tolerability, compliance and possible unexpected adverse events.
authors: Institute of Cardiovascular & Medical Sciences, University of Glasgow, Walton Building, Glasgow Royal Infirmary, Glasgow G4 0SF, Scotland, UK.
authors: Sarah
authors: S
authors: Marshall
authors: Patricia
authors: P
authors: Fearon
authors: Jesse
authors: J
authors: Dawson
authors: Terence J
authors: TJ
authors: Quinn
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D001562:Benzimidazoles / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D000069604:Dabigatran; D016527:Drug Costs; D006801:Humans; D018579:Patient Selection; D011314:Preventive Health Services / Q000191:economics*; D011725:Pyridines / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D001562:Benzimidazoles; D011725:Pyridines; D000069604:Dabigatran