Dabigatran Compared With Warfarin for Stroke Prevention in Atrial Fibrillation
Authors: David B. Edwards, John Silverberg
Journal: Annals of Internal Medicine (2011)

Letters19 April 2011Dabigatran Compared With Warfarin for Stroke Prevention in Atrial FibrillationDavid B. Edwards, MD and John Silverberg, PharmD, BCNSPDavid B. Edwards, MDFrom Banner Gateway Medical Center, Gilbert, AZ 85234.Search for more papers by this author and John Silverberg, PharmD, BCNSPFrom Banner Gateway Medical Center, Gilbert, AZ 85234.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-154-8-201104190-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Freeman and colleagues' cost-effectiveness analysis of dabigatran versus warfarin (1) accurately assessed the associated costs for payers of health care but not the true costs of care. The authors assumed that the costs of treating major hemorrhage would be identical to the 2008 Centers for Medicare & Medicaid Services diagnosis-related group reimbursement rates for both groups. This is not accurate. Fresh frozen plasma and vitamin K can treat severe bleeding due to warfarin. No reversal agent for dabigatran exists, but some investigators recommend recombinant activated factor VIIa (2), a substantially more expensive alternative than FFP or vitamin ...References1. Freeman JV, Zhu RP, Owens DK, Garber AM, Hutton DW, Go AS, et al. Cost-effectiveness of dabigatran compared with warfarin for stroke prevention in atrial fibrillation. Ann Intern Med. 2011;154:1-11. [PMID: 21041570] LinkGoogle Scholar2. van Ryn J, Stangier J, Haertter S, Liesenfeld KH, Wienen W, Feuring M, et al. Dabigatran etexilate—a novel, reversible, oral direct thrombin inhibitor: interpretation of coagulation assays and reversal of anticoagulant activity. Thromb Haemost. 2010;103:1116-27. [PMID: 20352166] CrossrefMedlineGoogle Scholar3. Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A, et al; RE-LY Steering Committee and Investigators. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361:1139-51. [PMID: 19717844] CrossrefMedlineGoogle Scholar4. Edwards DB, Heisler M, Guidry J, Jordan RM. Adverse drugs events leading to admission at a community non-teaching hospital. J Clin Outcomes Manag. 2007;14:389-94. [PMID: 19717844] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Banner Gateway Medical Center, Gilbert, AZ 85234.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCost-Effectiveness of Dabigatran Compared With Warfarin for Stroke Prevention in Atrial Fibrillation James V. Freeman , Ruo P. Zhu , Douglas K. Owens , Alan M. Garber , David W. Hutton , Alan S. Go , Paul J. Wang , and Mintu P. Turakhia Dabigatran Compared With Warfarin for Stroke Prevention in Atrial Fibrillation James V. Freeman and Mintu P. Turakhia Dabigatran Compared With Warfarin for Stroke Prevention in Atrial Fibrillation Alan M. Berg Metrics Cited byIs Dabigatran Cost Effective Compared With Warfarin for Stroke Prevention in Atrial Fibrillation? 19 April 2011Volume 154, Issue 8Page: 570KeywordsAtrial fibrillationBlood plasmaHealth careHemorrhageMedicareStrokeVitamin K ePublished: 19 April 2011 Issue Published: 19 April 2011 Copyright & PermissionsCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...