The Costs of an Irregular Heartbeat

A new study estimates the costs of treating atrial fibrillation as well as the comparative costs of treating it with warfarin and newer oral anticoagulants.

This article was originally published in Pharmacy Times. - See more at: http://www.hcplive.com/condition-resources/hyponatremia-resources/Disturbed-Osmoregulation-Pituitary-Associated-Hyponatremia-#sthash.ccRXCpSq.dpuf

This article was originally published in Pharmacy Times.

Atrial fibrillation (AF)—irregular, often rapid heartbeat—is closely linked to other cardiovascular diseases. Patients who have AF often have or develop heart failure, coronary artery disease (CAD), diabetes mellitus, hypertension, or valvular heart disease. Patients with AF are also at 4- to 5-times greater risk of stroke than are those who do not have AF.

AF’s predisposing risk factors and pathologic mechanisms are not fully understood. With 2.3 million Americans affected by AF, researchers are keenly interested in determining why this condition develops, how to prevent it, and the most effective treatments. The most common treatment is with anticoagulants to prevent stroke.

Until quite recently, warfarin was the only oral anticoagulant available. Warfarin’s limitations are well documented: It requires frequent monitoring, and patients exhibit widely variable responses that can increase the risk of bleeding or stroke. In addition, its many food and drug interactions pose challenges to patients and clinicians alike. Newer oral anticoagulants (eg, dabigatran, rivaroxaban, apixaban) offer more predictable anticoagulation without laboratory monitoring, but are comparatively costly.

An article published in the November/December 2013 issue of the Journal of Managed Care Pharmacy investigates whether the reduction in clinical events associated with the newer oral anticoagulants reduces medical costs and offsets their higher unit cost. The researchers used a literature search to identify studies conducted in the United States that examined anticoagulants for stroke prophylaxis in AF patients. Studies had to address costs of laboratory monitoring, bleeding, and stroke.

Much of what they found focused on short-term, in-hospital expenditures without attention to long-term care costs. Regardless, they were able to find ample data on AF-associated costs. They broke costs into 3 areas: (1) the costs of monitoring warfarin, (2) the direct costs of managing anticoagulant therapy’s adverse events (stroke and bleeding), and (3) the drug’s cost. Results were reported in 2011 US dollars.

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Atrial fibrillation (AF)—irregular, often rapid heartbeat—is closely linked to other cardiovascular diseases. Patients who have AF often have or develop heart failure, coronary artery disease (CAD), diabetes mellitus, hypertension, or valvular heart disease. Patients with AF are also at 4- to 5-times greater risk of stroke than are those who do not have AF.

AF’s predisposing risk factors and pathologic mechanisms are not fully understood. With 2.3 million Americans affected by AF, researchers are keenly interested in determining why this condition develops, how to prevent it, and the most effective treatments. The most common treatment is with anticoagulants to prevent stroke.

Until quite recently, warfarin was the only oral anticoagulant available. Warfarin’s limitations are well documented: It requires frequent monitoring, and patients exhibit widely variable responses that can increase the risk of bleeding or stroke. In addition, its many food and drug interactions pose challenges to patients and clinicians alike. Newer oral anticoagulants (eg, dabigatran, rivaroxaban, apixaban) offer more predictable anticoagulation without laboratory monitoring, but are comparatively costly.

An article published in the November/December 2013 issue of the Journal of Managed Care Pharmacy investigates whether the reduction in clinical events associated with the newer oral anticoagulants reduces medical costs and offsets their higher unit cost. The researchers used a literature search to identify studies conducted in the United States that examined anticoagulants for stroke prophylaxis in AF patients. Studies had to address costs of laboratory monitoring, bleeding, and stroke.

Much of what they found focused on short-term, in-hospital expenditures without attention to long-term care costs. Regardless, they were able to find ample data on AF-associated costs. They broke costs into 3 areas: (1) the costs of monitoring warfarin, (2) the direct costs of managing anticoagulant therapy’s adverse events (stroke and bleeding), and (3) the drug’s cost. Results were reported in 2011 US dollars.

- See more at: http://www.pharmacytimes.com/condition-resources/afib/The-Costs-of-an-Irregular-Heart-Beat#sthash.lgIvrrHS.dpuf