The cost of warfarin treatment for stroke prevention in patients with non-valvular atrial fibrillation in Russia from a collective perspective.
OBJECTIVE
Vitamin K antagonists (VKAs) are used for stroke prevention in patients with non-valvular atrial fibrillation (NVAF), but necessitate regular monitoring of prothrombin time via international normalized ratio (INR) testing. This study explores the economic burden of VKA therapy for Russian patients with NVAF.


METHODS
Cardiologists provided clinical characteristics and healthcare resource use data relating to the patient's first year of treatment. Data were used to quantify direct medical costs (INR testing, consultations, drug costs). The same patients completed a questionnaire providing data on direct non-medical costs (travel/expenses for attendance at VKA appointments) and indirect costs (opportunity cost and reduced work productivity). Mean costs per patient per year are described (US dollars).


RESULTS
Cardiologists (n = 50) provided data on 400 patients (mean age = 63, 47% female), and 351 patients (88%) completed the patient questionnaire. Patients had a mean of nine INR tests. Estimated direct medical costs totaled $151.06, and 18.5% of direct medical costs were attributable to drug costs. Estimated annual direct non-medical costs were $22.89 per patient, and indirect costs were $275.59 per patient.


CONCLUSIONS
Included patients had been treated for 12-24 months, so are not fully representative of the broader treatment population.


CONCLUSIONS
Although VKA drugs costs are relatively low, regular INR testing and consultations drive the economic burden for Russian NVAF patients treated with VKA.
a Bayer Pharma AG , Berlin , Germany.
J B
JB
Briere
a Bayer Pharma AG , Berlin , Germany.
K
K
Bowrin
b Adelphi Real World , Macclesfield , UK.
R
R
Wood
b Adelphi Real World , Macclesfield , UK.
J
J
Roberts
c Laboratory Research of Arrhythmology Federal Almazov North-West Medical Research Centre , St. Petersburg , Russia.
B
B
Tatarsky
D000368:Aged; D000925:Anticoagulants / Q000191:economics / Q000627:therapeutic use*; D000991:Antithrombins / Q000191:economics / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D015897:Comorbidity; D000069604:Dabigatran / Q000191:economics / Q000627:therapeutic use; D005260:Female; D015438:Health Behavior; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D017059:Models, Econometric; D010349:Patient Compliance / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D000069552:Rivaroxaban / Q000627:therapeutic use; D012426:Russia; D020521:Stroke / Q000517:prevention & control*; D014859:Warfarin / Q000191:economics / Q000627:therapeutic use*
D000925:Anticoagulants; D000991:Antithrombins; D014859:Warfarin; D000069552:Rivaroxaban; D000069604:Dabigatran
INR monitoring; NVAF; VKA; cost of treatment; warfarin