title: Comparison of hospital length of stay and hospitalization costs among patients with non-valvular atrial fibrillation treated with apixaban or warfarin: An early view.
abstract: OBJECTIVE
  To quantify and compare hospital length of stay (LOS) and costs between hospitalized non-valvular atrial fibrillation (NVAF) patients treated with either apixaban or warfarin via a large claims database.
  
  
  METHODS
  Adult patients hospitalized with AF were selected from the Premier Perspective Claims Database (01JAN2013-31MARCH2014). Patients with evidence of valvular heart disease, valve replacement procedures, or pregnancy during the index hospitalization were excluded. Patients treated with apixaban or warfarin during hospitalization were identified. Propensity score matching (PSM) was performed to control for baseline imbalances between patients treated with apixaban or warfarin. Primary outcomes were hospital LOS (days), post-medication administration LOS, and index hospitalization costs, and were compared using paired t-tests in the matched sample.
  
  
  RESULTS
  Before PSM, 2894 apixaban and 124,174 warfarin patients were identified. Patients treated with warfarin were older and sicker compared to those treated with apixaban. After applying PSM, a total of 2886 patients were included in each cohort, and baseline characteristics were balanced. The mean (standard deviation [SD] and median) hospital LOS was significantly (p = 0.002) shorter for patients treated with apixaban for 5.1 days (5.7 and 3) compared to warfarin for 5.5 days (4.8 and 4). The trend appeared consistent in the hospital LOS from point of apixaban or warfarin administration to discharge (4.5 vs 4.7 days, p = 0.051). Patients administered apixaban incurred significantly lower hospitalization costs compared to those administered warfarin ($11,262 vs $12,883; p < 0.001).
  
  
  CONCLUSIONS
  Among NVAF patients, apixaban treatment was associated with significantly shorter hospital LOS and lower costs when compared to warfarin treatment.
authors.affiliation: a STATinMED Research , Ann Arbor , MI , USA ;
authors.forename: Lin
authors.initials: L
authors.lastname: Xie
authors.affiliation: b Bristol-Myers Squibb , New York , NY , USA ;
authors.forename: Lien
authors.initials: L
authors.lastname: Vo
authors.affiliation: a STATinMED Research , Ann Arbor , MI , USA ;
authors.forename: Allison
authors.initials: A
authors.lastname: Keshishian
authors.affiliation: c Pfizer Inc. , New York , NY , USA ;
authors.forename: Kwanza
authors.initials: K
authors.lastname: Price
authors.affiliation: b Bristol-Myers Squibb , New York , NY , USA ;
authors.forename: Prianka
authors.initials: P
authors.lastname: Singh
authors.affiliation: c Pfizer Inc. , New York , NY , USA ;
authors.forename: Jack
authors.initials: J
authors.lastname: Mardekian
authors.affiliation: b Bristol-Myers Squibb , New York , NY , USA ;
authors.forename: Amanda
authors.initials: A
authors.lastname: Bruno
authors.affiliation: a STATinMED Research , Ann Arbor , MI , USA ;|d Columbia University , New York , NY , USA.
authors.forename: Onur
authors.initials: O
authors.lastname: Baser
authors.affiliation: b Bristol-Myers Squibb , New York , NY , USA ;
authors.forename: Jully
authors.initials: J
authors.lastname: Kim
authors.affiliation: c Pfizer Inc. , New York , NY , USA ;
authors.forename: Wilson
authors.initials: W
authors.lastname: Tan
authors.affiliation: c Pfizer Inc. , New York , NY , USA ;
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Trocio
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000925:Anticoagulants / Q000191:economics* / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy*; D015897:Comorbidity; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007345:Insurance Claim Review; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D011720:Pyrazoles / Q000191:economics* / Q000627:therapeutic use; D011728:Pyridones / Q000191:economics* / Q000627:therapeutic use; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D020521:Stroke / Q000191:economics / Q000517:prevention & control; D014859:Warfarin / Q000191:economics* / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D011720:Pyrazoles; D011728:Pyridones; C522181:apixaban; D014859:Warfarin
keywords: Apixaban; Length of stay; Non-VKA oral anticoagulants; Non-valvular atrial fibrillation; Warfarin