Clinical Outcome and Costs Based on the Degree of Vitamin K Antagonist Control for Non-Valvular Atrial Fibrillation

Area of Science:

• Pharmacology and Therapeutics
• Health Economics
• Public Health

Background:

• Effective anticoagulation control with vitamin K antagonists (VKAs) is crucial for managing non-valvular atrial fibrillation (NVAF).
• Understanding the economic impact of anticoagulation control is vital for healthcare decision-making.
• Real-world data analysis provides insights into VKA effectiveness in primary care settings.

Purpose of the Study:

• To analyze health outcomes and associated costs based on the degree of anticoagulation control using VKAs in NVAF patients.
• To evaluate the economic burden related to varying levels of anticoagulation control.
• To identify the impact of adequate anticoagulation on specific adverse events and mortality.

Main Methods:

• Analysis of real-world data from 42,374 NVAF patients in Catalonia, Spain (2018).
• Assessment of anticoagulation control using Rosendaal's time in therapeutic range (TTR), with >70% TTR defined as adequate control.
• Health system perspective with a 1-year time horizon, utilizing data from 325 primary care centers.

Main Results:

• 46.71% of patients achieved adequate anticoagulation control (TTR > 70%).
• Higher healthcare costs were observed in patients with poor anticoagulation control (EUR 1811.28) compared to adequate control (EUR 1609.25).
• Adequate TTR control significantly reduced odds of cranial hemorrhage (ORadj=0.75), gastrointestinal bleeding (ORadj=0.66), and mortality (ORadj=0.65).

Conclusions:

• Adequate anticoagulation control in NVAF patients is linked to reduced admissions for cranial hemorrhage and gastrointestinal bleeding.
• Improved anticoagulation management is associated with lower overall mortality rates.
• Implementing strategies to enhance anticoagulation control can lead to better patient outcomes and reduced healthcare expenditures.