Cost-effectiveness analysis of rivaroxaban plus aspirin versus aspirin alone in secondary prevention among patients with chronic cardiovascular diseases

doi:10.1007/s10557-020-07059-w

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Title:	Cost-effectiveness analysis of rivaroxaban plus aspirin versus aspirin alone in secondary prevention among patients with chronic cardiovascular diseases
Authors:	Lee, Mei-Chuan Liao, Chia-Te Toh, Han Siong Chou, Chih-Chen Chang, Wei-Ting Chen, Zhih-Cherng Wu, Wen-Shiann Yu, Tsung Strong, Carol
Contributors:	Chi Mei Med Ctr, Dept Pharm Natl Cheng Kung Univ, Dept Publ Hlth, Coll Med Chi Mei Med Ctr, Div Cardiol, Dept Internal Med Chi Mei Med Ctr, Dept Intens Care Med Natl Cheng Kung Univ, Inst Clin Med Kaohsiung Vet Gen Hosp, Dept Internal Med, Div Infect Dis Natl Cheng Kung Univ, Coll Management, Dept Stat Southern Taiwan Univ Sci & Technol, Dept Biotechnol Chia Nan Univ Pharm & Sci, Dept Pharm
Keywords:	Cost-effectiveness Rivaroxaban Cardiovascular diseases Coronary artery diseases Secondary prevention
Date:	2021
Issue Date:	2022-11-18 11:24:45 (UTC+8)
Publisher:	Springer
Abstract:	Purpose This study aimed to investigate the cost-effectiveness of low-dose rivaroxaban plus aspirin versus aspirin alone for patients with stable cardiovascular diseases in the Taiwan setting. Methods We constructed a Markov model to project the lifetime direct medical costs and quality-adjusted life-years of both therapies. Transitional probabilities were derived from the COMPASS trial, and the costs and utilities were obtained from the Taiwan National Health Insurance Database and published studies. One-way, scenario, subgroup, and probabilistic sensitivity analyses were performed to assess the uncertainty. Incremental cost-effectiveness ratio was presented as the outcome. The threshold of willingness-to-pay was set at US$76,368 (3 times the gross domestic product per capita of Taiwan). All analyses were operated by TreeAge 2019 and Microsoft Excel. Results The incremental cost-effectiveness ratios of rivaroxaban plus aspirin versus aspirin alone in the patients with stable cardiovascular diseases, coronary artery diseases, and peripheral artery diseases were US$83,459, US$69,852 and -US$13,823 per quality-adjusted life-year gained, respectively. The probabilistic sensitivity analyses showed that the probabilities of cost-effectiveness for the regimen with rivaroxaban among those with cardiovascular diseases and coronary artery diseases were 44.1% and 65.3% at US$76,368. Conclusion Low-dose rivaroxaban plus aspirin is less likely to be a cost-effective alternative to aspirin in secondary prevention for the patients with stable cardiovascular diseases; however, among these patients, the regimen may have pharmacoeconomic incentives for the group merely having chronic coronary artery diseases from the Taiwan national payer's perspective. The pharmacoeconomic incentives are influenced by the drug price, event treatment fees, and willingness-to-pay threshold.
Relation:	Cardiovascular Drugs and Therapy, v.35, n.3, pp.9
Appears in Collections:	[Dept. of Pharmacy] Periodical Articles

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