When Is Dabigatran More Cost-Effective Than Warfarin?

For patients with nonvalvular atrial fibrillation who are not well-controlled on warfarin, the 150-mg dose of dabigatran can be a cost-effective choice for stroke prevention.

Dabigatran, a direct thrombin inhibitor recently approved for preventing stroke in patients with nonvalvular atrial fibrillation, is much more expensive than warfarin but does not require blood draws to adjust dosing. Given that cost is one reason often cited for not adopting dabigatran as an alternative to warfarin, investigators for the U.K. Medical Research Council conducted a discrete-event cost-effectiveness simulation using data from the RE-LY randomized comparison of the two drugs (JW Cardiol Sep 1 2009). The RE-LY data were extrapolated to 50,000 U.K. National Health Service patients who were at moderately high risk for stroke (average CHADS₂ score, 2.1).

The 110-mg twice-daily dose of dabigatran, which is not approved for marketing …

Reviewing Author

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate

When Is Dabigatran More Cost-Effective Than Warfarin?

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Reviewing Author