When each device is compared incrementally , BioMonitor 2-AF dominates Reveal LINQ and Confirm RX .
BACKGROUND Cryptogenic stroke is a stroke for which no cause is identified after st and ard diagnostic tests .
Long-term implantable cardiac monitors may be better at diagnosing atrial fibrillation and provide an opportunity to reduce the risk of stroke recurrence with anticoagulants .
OBJECTIVES The objectives were to assess the diagnostic test accuracy , clinical effectiveness and cost-effectiveness of three implantable monitors [ BioMonitor 2-AF ™ ( Biotronik SE & Co. KG , Berlin , Germany ) , Confirm Rx ™ ( Abbott Laboratories , Lake Bluff , IL , USA ) and Reveal LINQ ™ ( Medtronic plc , Minneapolis , MN , USA ) ] in patients who have had a cryptogenic stroke and for whom no atrial fibrillation is detected after 24 hours of external electrocardiographic monitoring .
Cost-effectiveness of apixaban versus other new oral anticoagulants for stroke prevention in atrial fibrillation.
BACKGROUND Apixaban ( 5 mg BID ) , dabigatran ( available as 150 mg and 110 mg BID in Europe ) , and rivaroxaban ( 20 mg once daily ) are 3 novel oral anticoagulants ( NOACs ) currently approved for stroke prevention in patients with atrial fibrillation ( AF ) . OBJECTIVE The objective of this study was to evaluate the cost-effectiveness of apixaban against other NOACs from the perspective of the United Kingdom National Health Services . METHODS A Markov model was developed to evaluate the pharmacoeconomic impact of apixaban versus other NOACs over a lifetime . Pair-wise indirect treatment comparisons were conducted against other NOACs by using ARISTOTLE ( Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation ) , RE-LY ( R and omized Evaluation of Long-Term Anticoagulation Therapy ) , and ROCKET-AF ( Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation ) trial results for the following end points : ischemic stroke , hemorrhagic stroke , intracranial hemorrhage , other major bleeds , clinical ly relevant nonmajor bleeds , myocardial infa rct ion , and treatment discontinuations . Outcomes were life-years , quality -adjusted life years gained , direct health care costs , and incremental cost-effectiveness ratios . RESULTS Apixaban was projected to increase life expectancy versus other NOACs , including dabigatran ( both doses ) and rivaroxaban . A small increase in therapeutic management costs was observed with apixaban due to projected gains in life expectancy and lower discontinuation rates anticipated on apixaban versus other NOACs through lifetime . The estimated incremental cost-effectiveness ratio was £ 9611 , £ 4497 , and £ 5305 per quality -adjusted life-year gained with apixaban compared with dabigatran 150 mg BID , dabigatran 110 mg BID , and rivaroxaban 20 mg once daily , respectively . Sensitivity analyses indicated that results were robust over a wide range of inputs . CONCLUSIONS Although our analysis was limited by the absence of head-to-head trials , based on the indirect comparison data available , our model projects that apixaban may be a cost-effective alternative to dabigatran 150 mg BID , dabigatran 110 mg BID , and rivaroxaban 20 mg once daily for stroke prevention in AF patients from the perspective of the United Kingdom National Health Services
When each device is compared incrementally , BioMonitor 2-AF dominates Reveal LINQ and Confirm RX .
BACKGROUND Cryptogenic stroke is a stroke for which no cause is identified after st and ard diagnostic tests .
Long-term implantable cardiac monitors may be better at diagnosing atrial fibrillation and provide an opportunity to reduce the risk of stroke recurrence with anticoagulants .
OBJECTIVES The objectives were to assess the diagnostic test accuracy , clinical effectiveness and cost-effectiveness of three implantable monitors [ BioMonitor 2-AF ™ ( Biotronik SE & Co. KG , Berlin , Germany ) , Confirm Rx ™ ( Abbott Laboratories , Lake Bluff , IL , USA ) and Reveal LINQ ™ ( Medtronic plc , Minneapolis , MN , USA ) ] in patients who have had a cryptogenic stroke and for whom no atrial fibrillation is detected after 24 hours of external electrocardiographic monitoring .