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Analysis Of Health Care Costs Over A One-Year Period Following Anticoagulant Therapy Among Ontario Patients Diagnosed With Atrial Fibrillation, Michael Situ

Electronic Thesis and Dissertation Repository

Atrial fibrillation patients are at high risk of ischemic strokes, which can be drastically reduced using oral anticoagulants (OACs). Warfarin has been the standard OAC for this population but its effectiveness rests on consistent monitoring with the potential for severe bleeding events. Newer OACs, like rivaroxaban and apixaban, address these drawbacks but have a comparatively higher upfront cost. Uncertainty remains over which OAC is cost-saving from a health care system perspective. Using a retrospective cohort study design and inverse probability weighting regression adjustment estimators, one-year health care costs among patients treated with warfarin, rivaroxaban, and apixaban were compared. Compared to …

Cost-Effectiveness Analysis Of Pharmacogenomics (Pgx) Based Warfarin, Apixaban And Rivaroxaban Compared To Standard Warfarin For Atrial Fibrillation Patients In Canada, Aneeka Hafeez

Electronic Thesis and Dissertation Repository

This study assessed cost-effectiveness of pharmacogenomics (PGx)-based warfarin, apixaban and rivaroxaban compared to standard warfarin therapy for atrial fibrillation (AF) patients in Canada. A decision-analytic Markov model was developed to compare lifetime costs and quality-adjusted life years (QALYs) from the public healthcare payer perspective. The parameters applied in the model were derived from published literature and some costs from the IC/ES databases. The results were summarized in terms of the incremental cost-effectiveness ratio (ICER). Compared to standard warfarin, PGx-based warfarin care had an ICER of 17,727/QALY and apixaban had an ICER of $64,853/QALY gained. Apixaban dominated rivaroxaban. The probabilistic sensitivity …

Catheter Ablation For Atrial Fibrillation: Predicting Recurrence, Kendra Thomas

Electronic Thesis and Dissertation Repository

Background

Catheter ablation has emerged as treatment for atrial fibrillation (AF). Health care-related variables have not been explored as predictors of first ablation outcome. Determining factors associated with arrhythmia recurrence may help select patients likely to benefit. The objective was to identify variables associated with recurrence following AF ablation.

Methods

Retrospective cohort design of 314 AF patients who had undergone first ablation. Follow-up visits occurred at 3, 6 and 12 months. Variables and the outcome of recurrence were modeled with Cox proportional hazards analysis.

Results/Conclusions

After mean follow-up of 239+/-125 days, 110/314 patients (35.0%) experienced recurrence. Adjusted Cox proportional hazards …