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

Abstract

Aims: To describe the collective costs of vitamin K antagonist (VKA) treatment for stroke prevention in non-valvular atrial fibrillation (NVAF). VKA drug costs are relatively low, but they necessitate frequent international normalized ratio (INR) monitoring. There are currently minimal data describing the economic impact of this in Mexico.

Materials and methods: Cardiologists provided data on their NVAF patients (n = 400) to quantify direct medical costs (INR testing, appointments, drug costs). A sub-set of patients (n = 301) completed a patient questionnaire providing data to calculate direct non-medical costs (travel and other expenses for attendance at VKA-associated appointments) and indirect costs (opportunity cost and reduced work productivity associated with VKA treatment).

Results: Estimated annual direct medical costs totaled $753.6 per patient. Annual direct non-medical and indirect costs were USD$149.8 and $132.1, respectively.

Limitations: Recruited patients were those who consulted with a cardiologist during the study period and selected due to inclusion criteria. All had received uninterrupted treatment for 12–24 months. Consequently, the results are not fully generalizable to all VKA treated NVAF patients.

Conclusions: The true cost of VKA treatment cannot be appreciated by a consideration of drug costs alone. Ongoing monitoring appointments incur additional expenses for both patients and the healthcare system.

Keywords:

• Cost of treatment
• atrial fibrillation
• VKA
• anticoagulation
• warfarin

Transparency

Declaration of funding

The study was sponsored by Bayer Pharma AG.

Declaration of financial/other interests

JBB and KB are employed by Bayer Pharma AG. JME peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgements

The authors would like to thank Deirdre Carman for assistance with medical writing, and our Mexican colleague Jack Garcia Uranga who provided local support. Some of the data presented in this manuscript was presented at the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) conference 2016, Vienna.