title: Cost-effectiveness of Apixaban Compared With Edoxaban for Stroke Prevention in Nonvalvular Atrial Fibrillation.
abstract: OBJECTIVE
  The purpose of this analysis was to assess the cost-effectiveness of apixaban 5 mg BID versus high- and low-dose edoxaban (60 mg and 30 mg once daily) as intended starting dose strategies for stroke prevention in patients from a UK National Health Service perspective.
  
  
  METHODS
  A previously developed and validated Markov model was adapted to evaluate the lifetime clinical and economic impact of apixaban 5 mg BID versus edoxaban (high and low dose) in patients with nonvalvular atrial fibrillation. A pairwise indirect treatment comparison was conducted for clinical end points, and price parity was assumed between apixaban and edoxaban. Costs in 2012 British pounds, life-years, and quality-adjusted life-years (QALYs) gained, discounted at 3.5% per annum, were estimated.
  
  
  RESULTS
  Apixaban was predicted to increase life expectancy and QALYs versus low- and high-dose edoxaban. These gains were achieved at cost-savings versus low-dose edoxaban, thus being dominant and nominal increases in costs versus high-dose edoxaban. The incremental cost-effectiveness ratio of apixaban versus high-dose edoxaban was £6763 per QALY gained.
  
  
  CONCLUSIONS
  Apixaban was deemed to be dominant (less costly and more effective) versus low-dose edoxaban and a cost-effective alternative to high-dose edoxaban.
authors.affiliation: University of Birmingham, Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
authors.forename: Gregory Y H
authors.initials: GY
authors.lastname: Lip
authors.affiliation: Evidera, London, United Kingdom. Electronic address: Tereza.Lanitis@evidera.com.
authors.forename: Tereza
authors.initials: T
authors.lastname: Lanitis
authors.affiliation: Evidera, Bangkok, Thailand.
authors.forename: Thitima
authors.initials: T
authors.lastname: Kongnakorn
authors.affiliation: Bristol-Myers Squibb, Lawrence Township, New Jersey.
authors.forename: Hemant
authors.initials: H
authors.lastname: Phatak
authors.affiliation: Evidera, London, United Kingdom.
authors.forename: Corina
authors.initials: C
authors.lastname: Chalkiadaki
authors.affiliation: Pfizer, New York, New York; University of Tennessee College of Pharmacy, Memphis, Tennessee.
authors.forename: Xianchen
authors.initials: X
authors.lastname: Liu
authors.affiliation: Pfizer, New York, New York.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kuznik
authors.affiliation: Bristol-Myers Squibb, Lawrence Township, New Jersey.
authors.forename: Jack
authors.initials: J
authors.lastname: Lawrence
authors.affiliation: University of Toronto, St. Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Dorian
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000191:economics / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000191:economics; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008390:Markov Chains; D011720:Pyrazoles / Q000191:economics / Q000627:therapeutic use*; D011725:Pyridines / Q000191:economics / Q000627:therapeutic use*; D011728:Pyridones / Q000191:economics / Q000627:therapeutic use*; D019057:Quality-Adjusted Life Years; D020521:Stroke / Q000191:economics / Q000517:prevention & control*; D013844:Thiazoles / Q000191:economics / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D011720:Pyrazoles; D011725:Pyridines; D011728:Pyridones; D013844:Thiazoles; C522181:apixaban; C552171:edoxaban
keywords: apixaban; atrial fibrillation; clinical impact; cost-effectiveness; edoxaban