The cost of warfarin treatment for stroke prevention in patients with non-valvular atrial fibrillation in Russia from a collective perspective.

AIMS: Vitamin K antagonists (VKAs) are used for stroke prevention in patients with non-valvular atrial fibrillation (NVAF), but necessitate regular monitoring of prothrombin time via international normalized ratio (INR) testing. This study explores the economic burden of VKA therapy for Russian patients with NVAF. METHOD: Cardiologists provided clinical characteristics and healthcare resource use data relating to the patient's first year of treatment. Data were used to quantify direct medical costs (INR testing, consultations, drug costs). The same patients completed a questionnaire providing data on direct non-medical costs (travel/expenses for attendance at VKA appointments) and indirect costs (opportunity cost and reduced work productivity). Mean costs per patient per year are described (US dollars). RESULTS: Cardiologists (n = 50) provided data on 400 patients (mean age = 63, 47% female), and 351 patients (88%) completed the patient questionnaire. Patients had a mean of nine INR tests. Estimated direct medical costs totaled $151.06, and 18.5% of direct medical costs were attributable to drug costs. Estimated annual direct non-medical costs were $22.89 per patient, and indirect costs were $275.59 per patient. LIMITATIONS: Included patients had been treated for 12-24 months, so are not fully representative of the broader treatment population. CONCLUSION: Although VKA drugs costs are relatively low, regular INR testing and consultations drive the economic burden for Russian NVAF patients treated with VKA.

[Anticoagulation Therapy in Atrial Fibrillation and Congestive Heart Failure].

Modern data on the need to appoint oral anticoagulants in patients with atrial fibrillation and concomitant heart failure. Based on the Phase III study analysis comparing the direct oral anticoagulant warfarin and meta-analysis shows that taking direct oral coagulants no less effective and safer than warfarin in patients with atrial fibrillation and heart failure, which affects significantly fewer intracranial and heavy bleeding.

[Possible Choice of New Oral Anticoagulants With Non-Valvular Atrial Fibrillation: a Review of Meta-Analyzes].

This review presents the results of a meta-analysis including data from all four studies of new oral anticoagulants for the prevention of stroke or systemic embolism in patients with non-valvular atrial fibrillation. It was found that all of the drugs had a favorable risk profile/efficiency, and provides a significant reduction in the incidence of stroke, intracranial hemorrhage and mortality. This increases the number of gastrointestinal bleeding. The relative efficacy and safety of new oral anticoagulants is consistent in patients with different clinical characteristics. These data provide a more complete picture of the new oral anticoagulants as a therapeutic method of reducing the risk of stroke in this patient population.