Retrospective costing of warfarin
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Insights
Warfarin, an anticoagulant for atrial fibrillation, is not inexpensive when monitoring costs are considered. This study found total costs per patient per visit reached 70.07 Euros, impacting healthcare budgets and patients.
Area of Science:
- Pharmacoeconomics
- Health Services Research
- Cardiology
Background:
- Four anticoagulants are available in Ireland for atrial fibrillation stroke prevention.
- Newer anticoagulants offer redundant monitoring, unlike warfarin.
Purpose of the Study:
- To determine the total cost of warfarin treatment, including monitoring, from both patient and healthcare provider perspectives.
- To highlight the economic burden of warfarin monitoring.
Main Methods:
- Micro-costing methodology was employed.
- Costs were disaggregated from patient and healthcare provider viewpoints.
- A specific Cork hospital setting was used for the analysis.
Main Results:
- Healthcare provider costs per patient per clinic visit were €21.57.
- Patient costs per patient per clinic visit were €48.50.
- Total costs per patient per clinic visit amounted to €70.07.
Conclusions:
- Despite low pharmaceutical costs, warfarin therapy is expensive when monitoring expenses are factored in.
- Monitoring adds a significant economic burden to warfarin treatment.
- This cost analysis provides crucial data for anticoagulant prescribing decisions.
Abstract:
In Ireland, there are four anticoagulants available for prescribing to patients with atrial fibrillation for stroke prevention. A key feature of the three most recent anticoagulants is that monitoring is redundant. Despite this, there is continued prescribing of the incumbent anticoagulant, warfarin, which requires monitoring. Lack of information regarding the cost of monitoring, and the extra burden it places on health budgets and patients, motivated this costing study. Using micro costing, the costs of warfarin treatment (including monitoring) was disaggregated and isolated from both the patients' and health care provider's perspectives in a Cork hospital. Costs to the health care provider per patient per clinic visited were 21.57 Euros. Patient costs incurred per patient per clinic were 48.50 Euros. Thus, the total costs per patient per visit were 70.07 Euros. This result reveals that while the pharmaceutical cost of warfarin is low; it is not an inexpensive therapy when monitoring costs are considered.
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