Systematic review analysis of the cost-effectiveness of apixaban in stroke prevention in people with atrial fibrillation

Abstract

This study aims to synthesise studies on the cost-effectiveness of apixaban compared to current treatment regimens for stroke prevention in people with atrial fibrillation. This study uses a systematic literature review to evaluate the cost-effectiveness of apixaban in stroke prevention in people with atrial fibrillation across PubMed, The Cochrane Library, ScienceDirect, and Google Scholar databases. Results indicated that and 16 out of 19 studies (84.21%) demonstrated cost-effectiveness (including 6 regimens of apixaban with aspirin, 7 regimens of apixaban with warfarin, 3 regimens of apixaban with edoxaban, and 1 regimen of apixaban with dabigatran, rivaroxaban). Among them, 11 out of 16 studies received funding from Pfizer. Only 3 studies (15.79%) found apixaban not to be costeffective, including comparisons with warfarin in Norway, coumarin derivatives in Europe (UK), and warfarin in Canada. Among the 19 studies, 4 were conducted in Asian countries, including Japan, Saudi Arabia, Chinese Taipei, and China. All studies applied Markov or improved Markov models, and 17 out of 19 used a lifetime time frame.