By Lilian Anekwe
Evidence is emerging that a new generation of oral anticoagulants could be cost-effective alternatives to warfarin for atrial fibrillation.
A US modelling study based on UK prices of dabigatran – an oral direct thrombin inhibitor – found that although the higher doses of the drug fell just outside the NICE cost-effectiveness threshold, lower doses fell within the £30,000 per year cut-off.
The study, published in the latest issue of Annals of Internal Medicine, used a model comparing the use of clinic-adjusted warfarin to a target INR of 2.0 to 3.0 with twice-daily 110mg and twice-daily 150mg dabigatran.
The drug is currently licensed in the UK for venous thromboembolism prophylaxis after surgery.
Professor David Fitzmaurice, professor of primary care research at the University of Birmingham and anticoagulation lead for the Primary Care Cardiovascular Society, said: ‘Dabigatran is the first major advance in oral anticoagulation for over 60 years. More robust data on costs and effects are needed before excluding any particular dose based on an economic model.’
Dabigatran at lower doses is cost effective compared to warfarin