Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-4681
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dc.contributor.authorPletscher, Mark-
dc.contributor.authorPlessow, Rafael-
dc.contributor.authorEichler, Klaus-
dc.contributor.authorWieser, Simon-
dc.date.accessioned2018-08-17T08:29:56Z-
dc.date.available2018-08-17T08:29:56Z-
dc.date.issued2013-
dc.identifier.issn1424-7860de_CH
dc.identifier.issn1424-3997de_CH
dc.identifier.issn0036-7672de_CH
dc.identifier.urihttps://digitalcollection.zhaw.ch/handle/11475/9101-
dc.description.abstractOBJECTIVES: Atrial fibrillation is a major risk factor for ischemic stroke and anticoagulation therapy is indicated to reduce risk. Dabigatran is a new oral anticoagulant that does not require INR monitoring. This study evaluated the cost-effectiveness of dabigatran versus vitamin K antagonists for stroke prevention in atrial fibrillation in Switzerland. METHODS: A Markov model simulating the course of treatment and occurrence of clinical events in two treatment arms over the lifetime of patients was adapted to the Swiss context. The adaptation included the cost of anticoagulation therapy and clinical events in Switzerland. The cost of inpatient care was estimated on data of all inpatient hospital stays in 2008. The calculation of outpatient care costs was based on peer reviewed studies, expert interviews and local tariffs. RESULTS: Patients treated with dabigatran had a higher life expectancy and experienced more quality adjusted life years (QALY) while incurring higher costs than patients treated with vitamin K antagonists. The estimated incremental cost-effectiveness ratio (ICER) was CHF 25,108.‒ per QALY with 110 mg and CHF 9,702 per QALY with 150 mg of dabigatran. A sequential dosage scheme, in which 150 mg are administered up to the age of 80 years and 110 mg thereafter, resulted in an ICER of CHF 10,215 per QALY. A sensitivity analysis confirmed that these results are robust. CONCLUSIONS: Dabigatran can be considered cost-effective in comparison with vitamin K antagonists in the Swiss context. The higher drug cost of dabigatran is compensated by savings in INR monitoring, lower cost of clinical events and QALY-gains.de_CH
dc.language.isoende_CH
dc.publisherEMH Schweizerischer Ärzteverlagde_CH
dc.relation.ispartofSwiss medical weeklyde_CH
dc.rightshttp://creativecommons.org/licenses/by-nc-nd/4.0/de_CH
dc.subjectAntifibrinolytic agentsde_CH
dc.subjectAntithrombinsde_CH
dc.subjectAtrial fibrillationde_CH
dc.subjectBenzimidazolesde_CH
dc.subjectCost-benefit analysisde_CH
dc.subjectDabigatrande_CH
dc.subjectDrug dose-response relationshipde_CH
dc.subjectMarkov chainsde_CH
dc.subjectQuality of lifede_CH
dc.subjectQuality-adjusted life yearsde_CH
dc.subjectStrokede_CH
dc.subjectVitamin Kde_CH
dc.subjectBeta-Alaninede_CH
dc.subject.ddc362: Gesundheits- und Sozialdienstede_CH
dc.titleCost-effectiveness of dabigatran for stroke prevention in atrial fibrillation in Switzerlandde_CH
dc.typeBeitrag in wissenschaftlicher Zeitschriftde_CH
dcterms.typeTextde_CH
zhaw.departementSchool of Management and Lawde_CH
zhaw.organisationalunitWinterthurer Institut für Gesundheitsökonomie (WIG)de_CH
dc.identifier.doi10.4414/smw.2013.13732de_CH
dc.identifier.doi10.21256/zhaw-4681de_CH
dc.identifier.pmid23300013de_CH
zhaw.funding.euNode_CH
zhaw.issue143de_CH
zhaw.originated.zhawYesde_CH
zhaw.pages.end12de_CH
zhaw.pages.start1de_CH
zhaw.publication.statuspublishedVersionde_CH
zhaw.volume2013de_CH
zhaw.publication.reviewPeer review (Publikation)de_CH
Appears in Collections:Publikationen School of Management and Law

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