Pharmacoeconomics of Apixaban against Warfarin – A Review

Abstract

Atrial fibrillation, an irregular heartbeat, is a risk factor for various heart-related complications. Its prevalence increases with age and is expected to rise dramatically by 2030. Warfarin is traditionally prescribed to prevent strokes in atrial fibrillation patients, although it has its limits. Apixaban, a newer oral antithrombotic therapy, is effective in reducing strokes and bleeding. Several studies have examined the cost-effectiveness or value for money of Apixaban compared to Warfarin in different countries. In a study conducted in Japan, Apixaban was found to reduce strokes and bleeding events, leading to improved life years gained. Apixaban’s total cost per patient was higher, but it was still considered cost-effective. In a study from China, Apixaban also reduced strokes and bleeding compared to Warfarin. The expected life-years gained and quality-adjusted life-years gained were slightly lower compared to the Japanese study, but apixaban was still considered cost-effective. A study from Argentina showed similar results, with Apixaban reducing strokes and bleeding. The cost of Apixaban was higher than Warfarin, but Apixaban was still considered cost-effective based on incremental value-formoney ratios. Overall, the trials show that Apixaban offers better value for money than Warfarin for stroke prevention in atrial fibrillation patients. However, there were variations in the specific outcomes and costs among the countries studied. In Japan, the cost of Apixaban was higher and the life-years gained were greater compared to China and Argentina. Despite these variations, all three studies supported the fact that Apixaban was more value for money as compared to Warfarin.