The various risk stratification schemes classified variable proportions as low , moderate and high risk , but the CHA(2)DS(2)-VASc score classified the smallest proportion of patients as ' low risk ' .
Anticoagulation with vitamin K antagonists and dabigatran is cost-effective in patients at high risk of stroke , but not in patients without any other stroke risk factor beside AF .
Cost-effectiveness of dabigatran etexilate for the prevention of stroke and systemic embolism in atrial fibrillation: a Canadian payer perspective.
Oral dabigatran etexilate is indicated for the prevention of stroke and systemic embolism in patients with atrial fibrillation ( AF ) in whom anticoagulation is appropriate . Based on the RE-LY study we investigated the cost-effectiveness of Health Canada approved dabigatran etexilate dosing ( 150 mg bid for patients < 80 years , 110 mg bid for patients ≥80 years ) versus warfarin and " real-world " prescribing ( i.e. warfarin , aspirin , or no treatment in a cohort of warfarin-eligible patients ) from a Canadian payer perspective . A Markov model simulated AF patients at moderate to high risk of stroke while tracking clinical events [ primary and recurrent ischaemic strokes , systemic embolism , transient ischaemic attack , haemorrhage ( intracranial , extracranial , and minor ) , acute myocardial infa rct ion and death ] and result ing functional disability . Acute event costs and result ing long-term follow-up costs incurred by disabled stroke survivors were based on a Canadian prospect i ve study , published literature , and national statistics . Clinical events , summarized as events per 100 patient-years , quality -adjusted life years ( QALYs ) , total costs , and incremental cost effectiveness ratios ( ICER ) were calculated . Over a lifetime , dabigatran etexilate treated patients experienced fewer intracranial haemorrhages ( 0.49 dabigatran etexilate vs. 1.13 warfarin vs. 1.05 " real-world " prescribing ) and fewer ischaemic strokes ( 4.40 dabigatran etexilate vs. 4.66 warfarin vs. 5.16 " real-world " prescribing ) per 100 patient-years . The ICER  of dabigatran etexilate was $ 10,440/QALY versus warfarin and $ 3,962/QALY versus " real-world " prescribing . This study demonstrates that dabigatran etexilate is a highly cost-effective alternative to current care for the prevention of stroke and systemic embolism among Canadian AF patients
The various risk stratification schemes classified variable proportions as low , moderate and high risk , but the CHA(2)DS(2)-VASc score classified the smallest proportion of patients as ' low risk ' .
Anticoagulation with vitamin K antagonists and dabigatran is cost-effective in patients at high risk of stroke , but not in patients without any other stroke risk factor beside AF .