Apixaban improves outcomes, drives healthcare costs down for NVAF patients

Apixaban reduces the risk of stroke/systemic embolism (SE) and major bleeding in nonvalvular atrial fibrillation (NVAF) patients with peripheral (PAD) or coronary (CAD) artery disease, a recent study has found.

In turn, associated healthcare costs are also lower with apixaban vs other agents such as warfarin, dabigatran, or rivaroxaban.

The study included 33,269 warfarin-apixaban, 9,335 dabigatran-apixaban, and 33,633 rivaroxaban-apixaban matched pairs for comparison. Cox proportional hazards analysis found that patients on warfarin were at a significantly higher risk of stroke/SE, major bleeding, and all-cause mortality than their apixaban counterparts (p<0.001 for all).

The likelihood of the composite among stroke, myocardial infarction, and all-cause mortality was likewise significantly elevated in warfarin vs apixaban patients (p<0.001).

Notably, repeating the analyses for dabigatran and rivaroxaban, the researchers saw that the risk estimates for all outcomes were similarly suppressed in those taking apixaban, to a significant degree. The only exceptions were all-cause mortality and the composite outcome, which did not differ between dabigatran and apixaban.

Generalized linear models were then constructed to compare mean healthcare costs between treatment groups. In all cases, patients on apixaban accrued significantly less healthcare costs than comparators.

“These findings provide an assessment of oral anticoagulant treatment in NVAF patients with coexisting CAD/PAD, which may offer valuable information for clinical and policy decision making,” the researchers said.