CLINICAL AND ECONOMICAL COMPARISON OF RIVAROXABAN AND APIXABAN USE IN PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION

Abstract

Aim. To compare cost-effectiveness of the use of direct factor Xa inhibitors rivaroxaban and apixaban in patients with non-valvular atrial fibrillation (AF) and to assess the impact of the both therapies on the healthcare budget of Russian Federation.Material and methods. Pharmacoeconomic analysis with "decision tree" modeling is performed. The costs of regimens using rivaroxaban and apixaban were calculated. Assessment of the likelihood of cerebrovascular complications during anticoagulant therapy was performed, and the average additional costs in development of adverse clinical effects were calculated. The average costs of treatment regimens used in view of the probability of occurrence of all the clinical effects, were calculated as a result of the modeling.Results. The results of the pharmacoeconomic analysis shown, that the strategy of the use of rivaroxaban for stroke prevention in patients with non-valvular AF is less costly 49558.43 rubles for one patient per year. The strategy of apixaban application costs higher by 0.15% (50027.57 rubles). Cost reduction for the year of rivaroxaban therapy in a cohort of 1000 patients was 469140 rubles due to decrease in the incidence of cerebrovascular complications in comparison with apixaban therapy.Conclusion. When choosing pharmacotherapy strategy to prevent the stroke in patients with non-valvular AF rivaroxaban use is more effective, than the use of apixaban, from the clinical and pharmacoeconomic points of view.

Keywords

• pharmacoeconomic analysis
• atrial fibrillation
• stroke
• rivaroxaban
• apixaban