PURPOSE: Three new oral anticoagulants (NOACs) have recently become available in the United Kingdom as an alternative to @entity1229 in the prevention of @entity64 in @entity955 . This study examines the relative cost-effectiveness of @entity3926 (BID dosing of 150 mg or 110 mg based on @entity1 age), @entity3925 , and @entity5424 from a UK payer perspective. METHODS: A previously published model that follows up @entity1 through treatment of @entity955 during a lifetime was adapted to allow comparison of the 3 NOACs and @entity1229 . Acute @entity1031 and bleeding events, as well as long-term consequences of @entity64 , @entity932 , and acute @entity583 , were tracked. Relative efficacy was calculated from a formal indirect treatment comparison using data from the 3 key trials (Randomized Evaluation of Long-Term Anticoagulation Therapy, @entity3925 Once-daily oral direct factor Xa inhibition Compared with @entity2067 antagonism for prevention of @entity64 and Embolism Trial in @entity955 , and @entity5424 for the Prevention of @entity64 in Subjects With @entity955 ) of the NOACs. Data from the @entity3925 trial were adjusted for the difference in international normalized ratio control among @entity1229 @entity1 versus the other 2 trials. Model outputs included total costs, event rates, and quality-adjusted life-years. FINDINGS: Among the @entity1 taking NOACs, those taking @entity3926 had the highest total QALYs (7.68 QALYs), followed by @entity5424 (7.63 QALYs) and @entity3925 (7.47 QALYs). @entity1 taking @entity3926 had the lowest total lifetime costs (  23,342), followed by @entity5424 (  24,014) and @entity3925 (  25,220). The differences between @entity3926 and @entity5424 were modest but consistent in sensitivity analyses, with the directionality only changing at the limits of the CIs for the relative risks of @entity385 or @entity932 or when assuming that both treatment discontinuation and post-event disability rates differ by drug. IMPLICATIONS: @entity3926 was found to be economically dominant over @entity3925 and @entity5424 in the UK setting. These economic findings are based on relative clinical efficacy from an indirect treatment comparison and would benefit from any data of direct comparisons of the NOACs in the future.

Comparison of the Cost-effectiveness of New Oral Anticoagulants for the Prevention of XXXX in @entity955 in a UK Setting.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke and systemic embolism', 'stroke', 'Stroke'] @entity932 :: ('MESH:D020300', 'Disease') :: ['intracranial hemorrhage'] @entity2067 :: ('MESH:D014812', 'Chemical') :: ['vitamin K'] @entity3926 :: ('MESH:C554682', 'Chemical') :: ['Dabigatran', 'dabigatran'] @entity3925 :: ('MESH:C503223', 'Chemical') :: ['Rivaroxaban', 'rivaroxaban'] @entity5424 :: ('MESH:C522181', 'Chemical') :: ['Apixaban', 'apixaban'] @entity1031 :: ('MESH:D013923', 'Disease') :: ['thromboembolic'] @entity955 :: ('MESH:D001281', 'Disease') :: ['atrial fibrillation', 'Atrial Fibrillation'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction'] @entity1229 :: ('MESH:D014859', 'Chemical') :: ['warfarin'] @entity385 :: ('MESH:D002544', 'Disease') :: ['ischemic stroke']
@entity64 :: (MESH:D020521,Disease) :: ['Stroke and Systemic Embolism']
