COST – EFFECTIVENESS ANALYSIS OF NOVEL ORAL ANTICOAGULANTS IN THE PREVENTION OF STROKE AND SYSTEMATIC EMBOLISM IN PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION IN VIETNAM
Main Article Content
Abstract
Background: Non-valvular atrial fibrillation (NVAF) is one of the diseases with leading prevalence and mortality rates worldwide. In addition to the disease burden, this condition imposes significant economic consequences for patients and society. Currently, novel oral anticoagulants (NOACs) are increasingly utilized for the prevention of thromboembolism. However, in Vietnam, research on the cost-effectiveness (CEA) of NOACs remains limited. Method: Cost-effectiveness analysis from the perspective of the health insurance payer, based on a Markov model, using input data collected from clinical trials, literature reviews, and expert opinions; drug cost data was referenced from the circular issued by the Ministry of Health. Results: The study results showed that apixaban was dominant over other NOACs (rivaroxaban and dabigatran), dabigatran was dominant over rivaroxaban in preventing stroke and systemic embolism in NVAF patients. Compared to VKAs, NOACs had an ICER/QALY ranging from 396,604,064 VND to 1,691,290,848 VND. Compared to the threshold of three times of gross domestic product per capita of Vietnam in 2023 (equivalent to 305.7 million VND), NOACs were not cost-effective compared to VKAs in preventing stroke and systemic embolism in NVAF patients. Conclusion: A cost-effectiveness analysis (CEA) in Vietnam from the perspective of the healthcare payer indicates that apixaban is cost-saving and more effective, thereby demonstrating superiority over other NOACs (rivaroxaban and dabigatran) in the prevention of stroke and systematic embolism in patients with NVAF.
Article Details
Keywords
novel oral anticoagulant, non-valvular atrial fibrillation, NOAC, NVAF, cost-effectiveness
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