Patient-specific and healthcare real-world costs of atrial fibrillation in individuals treated with direct oral anticoagulant agents or warfarin

Mikko Pyykonen*, Miika Linna, Markku Tykkylainen, Eric Delmelle, Tiina Laatikainen

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

9 Downloads (Pure)

Abstract

Background: Anticoagulant therapies are used to prevent atrial fibrillation-related strokes, with warfarin and direct oral anticoagulant (DOAC) the most common. In this study, we incorporate direct health care costs, drug costs, travel costs, and lost working and leisure time costs to estimate the total costs of the two therapies. Methods: This retrospective study used individual-level patient data from 4000 atrial fibrillation (AF) patients from North Karelia, Finland. Real-world data on healthcare use was obtained from the regional patient information system and data on reimbursed travel costs from the database of the Social Insurance Institution of Finland. The costs of the therapies were estimated between June 2017 and May 2018. Using a Geographical Information System (GIS), we estimated travel time and costs for each journey related to anticoagulant therapies. We ultimately applied therapy and travel costs to a cost model to reflect real-world expenditures. Results: The costs of anticoagulant therapies were calculated from the standpoint of patient and the healthcare service when considering all costs from AF-related healthcare visits, including major complications arising from atrial fibrillation. On average, the annual cost per patient for healthcare in the form of public expenditure was higher when using DOAC therapy than warfarin therapy (average cost = € 927 vs. € 805). Additionally, the average annual cost for patients was also higher with DOAC therapy (average cost = € 406.5 vs. € 296.7). In warfarin therapy, patients had considerable more travel and time costs due the different implementation practices of therapies. Conclusion: The results indicated that DOAC therapy had higher costs over warfarin from the perspectives of the patient and healthcare service in the study area on average. Currently, the cost of the DOAC drug is the largest determinator of total therapy costs from both perspectives. Despite slightly higher costs, the patients on DOAC therapy experienced less AF-related complications during the study period.

Original languageEnglish
Article number1299
Number of pages15
JournalBMC HEALTH SERVICES RESEARCH
Volume21
Issue number1
DOIs
Publication statusPublished - 3 Dec 2021
MoE publication typeA1 Journal article-refereed

Keywords

  • Real-world data
  • GIS
  • Time and travel costs
  • Cost model
  • Electronic health records
  • EPIDEMIOLOGY
  • TRENDS
  • DABIGATRAN
  • CHOICE
  • TRAVEL

Fingerprint

Dive into the research topics of 'Patient-specific and healthcare real-world costs of atrial fibrillation in individuals treated with direct oral anticoagulant agents or warfarin'. Together they form a unique fingerprint.

Cite this