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Real-world data suggest that, in the first year of treatment with an anticoagulant, patients with non-valvular atrial fibrillation tend to use fewer healthcare resources if they receive dabigatran rather than warfarin.
Patients treated with dabigatran experienced fewer all-cause hospitalizations, emergency room (ER) visits, and physician office visits than patients treated with warfarin.
These findings were published in The American Journal of Pharmacy Benefits.
The research was supported by Boehringer Ingelheim Pharmaceuticals, Inc., the company that markets dabigatran as Pradaxa.
“While there are many published studies comparing the clinical outcomes of [dabigatran] and warfarin, this is one of the first to compare their respective impact on the use of healthcare resources,” said study author Matthew Sussman, of Boston Health Economics, Inc. in Waltham, Massachusetts.
“Beyond data from clinical studies, it is important for physicians to also understand the experiences patients have in real-world settings, including the economic considerations of their treatment choices.”
Sussman and his colleagues analyzed data on 3890 patients newly diagnosed with non-valvular atrial fibrillation—1945 treated with dabigatran and 1945 treated with warfarin—using de-identified electronic health records from a large, nationwide database of US integrated delivery networks.
Patients in the warfarin cohort were propensity-score matched 1:1 to patients in the dabigatran cohort and were followed up to 1 year after initiating therapy to assess all-cause, stroke-related, and bleed-related healthcare resource use.
The researchers found that dabigatran-treated patients had a significantly lower number of mean per-patient per-year (PPPY) hospitalizations (1.07 vs 1.20, P<0.001), ER visits (0.36 vs 0.51, P<0.001), and physician office visits (10.64 vs 18.13, P<0.001) than patients treated with warfarin.
When it came to stroke-related resource use, dabigatran-treated patients had a significantly lower number of mean PPPY hospitalizations (0.06 vs 0.10, P=0.03) and physician office visits (0.16 vs 0.29, P=0.02). But the difference in ER visits between the dabigatran and warfarin groups was not significant (0 vs 0.01, P=0.65).
As for bleed-related resource use, there was no significant difference between the dabigatran and warfarin groups with regard to the mean number of PPPY hospitalizations (0.05 vs 0. 03, P=0.49) or physician office visits (0.05 vs 0.15, P=0.57). But the difference in ER visits was significant (0.01 vs 0.03, P=0.02).
