CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

November 2nd, 2010

Is Dabigatran More Cost-Effective Than Warfarin in AF?

Dabigatran, newly approved by the FDA to prevent stroke in patients with atrial fibrillation (AF), might turn out to be a cost-effective alternative to warfarin, according to an Annals of Internal Medicine study. Using data from the RE-LY trial, James Freeman and colleagues modeled the quality-adjusted survival and cost-effectiveness of dabigatran compared with high- or low-dose warfarin among adults older than 65 with AF. Cost was estimated based on current pricing in the U.K., where dabigatran has been approved since 2008.

The researchers found that high-dose dabigatran was the most efficacious and cost-effective strategy. Depending on pricing in the U.S., they conclude, the new drug might prove to be a more cost-effective option than warfarin. (Last week, CardioExchange reported that dabigatran will cost about $237/month at U.S. pharmacies.)

Comments are closed on this post, but please join the conversation at our Dabigatran Resource Round-Up.

Categories: Anticoagulation, Electrophysiology, General, Prevention
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3 Responses to “Is Dabigatran More Cost-Effective Than Warfarin in AF?”

  1. Giuseppe Marino Benvenuto, MD says:
    November 4, 2010 at 8:04 am

    I think it will be useful to repeat these analyses after the RE-LY study when Dabigatran will be used in the real world? It will be the same results? I hope so…

    Competing interests pertaining specifically to this post, comment, or both:
    none

  2. Howard Holtz, MD says:
    November 4, 2010 at 2:17 pm

    Prescriber’s Letter stated dabigatran will probably not be cost-effective, “Dabigatran costs about $8/day…which is more than the cost of warfarin PLUS monitoring.” They also point out it is bid, which may affect compliance. Is the pricing in the UK comparable to the US or do we, as usual, pay more for the same med?

    Competing interests pertaining specifically to this post, comment, or both:
    none

  3. Gary Raffel, DO, FACP says:
    November 4, 2010 at 3:31 pm

    another issue effecting overall cost is the associated morbidity of increased gastrointestinal bleeding events with the high dose(150mg)of dabigatran, including hospitalization, endoscopy, etc; the dabigatran requires a lower pH for increased gastrointestinal absorption which may explain this increase in gastrointestinal bleeding.