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Original Research

Comparison of all-cause, stroke, and bleed-specific healthcare resource utilization among patients with non-valvular atrial fibrillation (NVAF) and newly treated with dabigatran or warfarin

, , , , , , & show all
Pages 213-222 | Received 27 Apr 2017, Accepted 22 Jun 2017, Published online: 03 Jul 2017
 

ABSTRACT

Background: We compared healthcare utilization outcomes and persistence among non-valvular atrial fibrillation (NVAF) patients newly treated with dabigatran or warfarin.

Methods: Using a nationwide, US administrative claims database, a retrospective matched-cohort of newly diagnosed NVAF patients (age≥18 years) treated with dabigatran or warfarin (propensity score matched 1:1) in 01/01/2011–12/31/2013 was evaluated. All-cause, stroke-, and bleed-specific per patient per month (PPPM) healthcare resource utilization (HCRU), incidence rate of hospitalization for stroke or bleed, 30-day readmission, and persistence were reported.

Results: In total, 18,890 dabigatran patients were matched to corresponding warfarin patients. Compared to warfarin users, dabigatran users PPPM had significantly fewer all-cause hospitalizations (0.04 vs 0.05), total outpatient visits (3.98 vs 5.87), and lower 30-day readmissions (14.5% vs 17.4%, all p < 0.001). Dabigatran users had lower incidence rate for stroke (0.65 vs 1.06) and bleed (1.69 vs 2.20), stroke (0.0006 vs 0.0011, p < 0.001) and bleed-specific hospitalizations (0.002 vs 0.003, p = 0.008), and stroke (0.03 vs 0.04, p < 0.001) and bleed-specific outpatient visits (0.07 vs 0.08, p = 0.018), and significantly lower non-persistence (62.1% vs 66.3%, p < 0.001).

Conclusion: Among newly diagnosed newly treated NVAF patients, dabigatran users had significantly lower all-cause, stroke- and bleed-specific HCRU, lower risk of hospitalization for stroke or bleed events, lower 30-day readmissions, and higher persistence than warfarin users.

Declaration of interest

This work was supported by Boehringer Ingelheim Pharmaceuticals, Inc. This study was conducted by Truven Health Analytics, an IBM Company, USA. A Gilligan, X Song, C Henriques, and DM Smith are employees of Truven Health Analytics which received compensation from Boehringer-Ingelheim Pharmaceuticals Inc., for the overall conduct of the study and preparation of this manuscript. P Gandhi, C Wang, and S Sander are employees of Boehringer-Ingelheim Pharmaceuticals Inc. Prachi Arora was an intern at Boehringer Ingelheim when this study was conducted and during writing of the manuscript.

Editorial/medical writing assistance for the preparation of this manuscript was provided by Lorena Lopez-Gonzalez, PhD (an employee of Truven Health Analytics, an IBM Company) and funded by Boehringer-Ingelheim Pharmaceuticals Inc.

Supplemental data

Supplemental data for this article can be accessed here.

Additional information

Funding

This work was supported by Boehringer Ingelheim Pharmaceuticals, Inc.

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