Cost-effectiveness of dabigatran in stroke prevention

In our recent publication, we analysed the cost-effectiveness of dabigatran in the prevention of stroke for patients with atrial fibrillation. The published analyses are based on a prior, unpublished health economic assessment that has been evaluated by FIMEA in its pilot project. The health care costs and drug prices were updated to year 2011 level for the published cost-effectiveness assessment.

In the base case scenario an additional quality adjusted life year (QALY) cost 13,410 euro with dabigatran compared to warfarin. In the performed sensitivity analyses the incremental cost-effectiveness ratios (ICERs) ranged from 175 to 25,948 euros per QALY gained. When dabigatran was compared to ASA and no treatment, the ICERs were even lower: 9,816 euros/QALY gained and 4,514 euros/QALY gained, respectively.

The cost difference between dabigatran and warfarin that is caused by the Finnish Pharmaceutical Pricing Scheme inflate the obtained ICERs artificially. In a wholesale price based cost-effectiveness analysis an additional QALY with dabigatran cost only 495 euros when compared to warfarin.

The performed analyses suggest that dabigatran can be considered as a potentially cost-effective treatment alternative for stroke prevention among patients with atrial fibrillation.

More information: Taru Hallinen, Erkki Soini

References: Hallinen T, Soini E, Tuovinen M. Dabigatraanin kustannusvaikuttavuus eteisvärinäpotilaiden aivohalvausten ehkäisyssä. Dosis 2012:2:130-144.