Andre Lamy, John Eikelboom, Wesley Tong, Fei Yuan, Shrikant I. Bangdiwala, Jackie Bosch, Stuart Connolly, Eva Lonn, Gilles R. Dagenais, Kelley R. H. Branch, Wei-Jhih Wang, Deepak L. Bhatt, Jeffrey Probstfield, Georg Ertl, Stefan Störk, P. Gabriel Steg, Victor Aboyans, Isabelle Durand-Zaleski, Lars Ryden, Salim Yusuf
{"title":"COMPASS 试验中利伐沙班加阿司匹林与单用阿司匹林的成本效益比较：美国视角。","authors":"Andre Lamy, John Eikelboom, Wesley Tong, Fei Yuan, Shrikant I. Bangdiwala, Jackie Bosch, Stuart Connolly, Eva Lonn, Gilles R. Dagenais, Kelley R. H. Branch, Wei-Jhih Wang, Deepak L. Bhatt, Jeffrey Probstfield, Georg Ertl, Stefan Störk, P. Gabriel Steg, Victor Aboyans, Isabelle Durand-Zaleski, Lars Ryden, Salim Yusuf","doi":"10.1007/s40256-023-00620-6","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Rivaroxaban 2.5 mg twice daily with aspirin 100 mg daily was shown to be better than aspirin 100 mg daily for preventing cardiovascular (CV) death, stroke or myocardial infarction in patients with either stable coronary artery disease (CAD) or peripheral artery disease (PAD). The cost-effectiveness of this regimen in this population is essential for decision-makers to know.</p><h3>Methods</h3><p>US direct healthcare system costs (in USD) were applied to hospitalized events, procedures and study drugs utilized by all patients. We determined the mean cost per participant for the full duration of the trial (mean follow-up of 23 months) plus quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) over a lifetime using a two-state Markov model with 1-year cycle length. Sensitivity analyses were performed on the price of rivaroxaban and the annual discontinuation rate.</p><h3>Results</h3><p>The costs of events and procedures were reduced for Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) patients who received rivaroxaban 2.5 mg orally (BID) plus acetylsalicylic acid (ASA) compared with ASA alone. Total costs were higher for the combination group ($7426 versus $4173) after considering acquisition costs of the study drug. Over a lifetime, patients receiving rivaroxaban plus ASA incurred $27,255 more and gained 1.17 QALYs compared with those receiving ASA alone resulting in an ICER of $23,295/QALY. ICERs for PAD only and polyvascular disease subgroups were lower.</p><h3>Conclusion</h3><p>Rivaroxaban 2.5 mg BID plus ASA compared with ASA alone was cost-effective (high value) in the USA.</p><p><b>COMPASS ClinicalTrials.gov identifier</b>: NCT01776424.</p></div>","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"24 1","pages":"117 - 127"},"PeriodicalIF":2.8000,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10806169/pdf/","citationCount":"0","resultStr":"{\"title\":\"The Cost-Effectiveness of Rivaroxaban Plus Aspirin Compared with Aspirin Alone in the COMPASS Trial: A US Perspective\",\"authors\":\"Andre Lamy, John Eikelboom, Wesley Tong, Fei Yuan, Shrikant I. Bangdiwala, Jackie Bosch, Stuart Connolly, Eva Lonn, Gilles R. Dagenais, Kelley R. H. Branch, Wei-Jhih Wang, Deepak L. Bhatt, Jeffrey Probstfield, Georg Ertl, Stefan Störk, P. Gabriel Steg, Victor Aboyans, Isabelle Durand-Zaleski, Lars Ryden, Salim Yusuf\",\"doi\":\"10.1007/s40256-023-00620-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Rivaroxaban 2.5 mg twice daily with aspirin 100 mg daily was shown to be better than aspirin 100 mg daily for preventing cardiovascular (CV) death, stroke or myocardial infarction in patients with either stable coronary artery disease (CAD) or peripheral artery disease (PAD). The cost-effectiveness of this regimen in this population is essential for decision-makers to know.</p><h3>Methods</h3><p>US direct healthcare system costs (in USD) were applied to hospitalized events, procedures and study drugs utilized by all patients. We determined the mean cost per participant for the full duration of the trial (mean follow-up of 23 months) plus quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) over a lifetime using a two-state Markov model with 1-year cycle length. Sensitivity analyses were performed on the price of rivaroxaban and the annual discontinuation rate.</p><h3>Results</h3><p>The costs of events and procedures were reduced for Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) patients who received rivaroxaban 2.5 mg orally (BID) plus acetylsalicylic acid (ASA) compared with ASA alone. Total costs were higher for the combination group ($7426 versus $4173) after considering acquisition costs of the study drug. Over a lifetime, patients receiving rivaroxaban plus ASA incurred $27,255 more and gained 1.17 QALYs compared with those receiving ASA alone resulting in an ICER of $23,295/QALY. 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The Cost-Effectiveness of Rivaroxaban Plus Aspirin Compared with Aspirin Alone in the COMPASS Trial: A US Perspective
Background
Rivaroxaban 2.5 mg twice daily with aspirin 100 mg daily was shown to be better than aspirin 100 mg daily for preventing cardiovascular (CV) death, stroke or myocardial infarction in patients with either stable coronary artery disease (CAD) or peripheral artery disease (PAD). The cost-effectiveness of this regimen in this population is essential for decision-makers to know.
Methods
US direct healthcare system costs (in USD) were applied to hospitalized events, procedures and study drugs utilized by all patients. We determined the mean cost per participant for the full duration of the trial (mean follow-up of 23 months) plus quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) over a lifetime using a two-state Markov model with 1-year cycle length. Sensitivity analyses were performed on the price of rivaroxaban and the annual discontinuation rate.
Results
The costs of events and procedures were reduced for Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) patients who received rivaroxaban 2.5 mg orally (BID) plus acetylsalicylic acid (ASA) compared with ASA alone. Total costs were higher for the combination group ($7426 versus $4173) after considering acquisition costs of the study drug. Over a lifetime, patients receiving rivaroxaban plus ASA incurred $27,255 more and gained 1.17 QALYs compared with those receiving ASA alone resulting in an ICER of $23,295/QALY. ICERs for PAD only and polyvascular disease subgroups were lower.
Conclusion
Rivaroxaban 2.5 mg BID plus ASA compared with ASA alone was cost-effective (high value) in the USA.
期刊介绍：
Promoting rational therapy within the discipline of cardiology, the American Journal of Cardiovascular Drugs covers all aspects of the treatment of cardiovascular disorders, particularly the place in therapy of newer and established agents.
Via a program of reviews and original clinical research articles, the journal addresses major issues relating to treatment of these disorders, including the pharmacology, efficacy and adverse effects of the major classes of drugs; information on newly developed drugs and drug classes; the therapeutic implications of latest research into the aetiology of cardiovascular disorders; and the practical management of specific clinical situations.
The American Journal of Cardiovascular Drugs offers a range of additional enhanced features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by a Key Points summary, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist patients, caregivers and others in understanding important medical advances. The journal also provides the option to include various other types of enhanced features including slide sets, videos and animations. All enhanced features are peer reviewed to the same high standard as the article itself. Peer review is conducted using Editorial Manager®, supported by a database of international experts. This database is shared with other Adis journals.
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