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New methods for evaluation and treatment: Artery disease

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Cost-effective Intervention for the Prevention of Cardiovascular Events

There has not been much evidence on the cost-effectiveness of approved interventions for the prevention of cardiovascular events among individuals with chronic coronary syndrome (stable coronary artery disease) or symptomatic peripheral artery disease at risk of cardiovascular complications in Finland. Soini et al. studied the cost-effectiveness, cost-utility, value of information, and economic value-added (EVA) of rivaroxaban when prescribed in combination with acetylsalicylic acid.

The study also included method developments:

  • EVA is a new method which combines both the monetary gain (benefit) and opportunity cost (risk) of intervention and can be presented as EVAC (economic value-added curve).
  • Future decisions of drug treatment initiation can be modelled by predicting e.g. the pharmaceutical market and costs of events for the decision year. Here, the prediction of future was beneficial for the intervention.
  • PICOSTEPS principle was also applied for the sensitivity analysis content development.

In line with the clinical rationale, the researchers set out to examine if intensified antithrombosis with rivaroxaban 2.5 mg twice daily in addition to acetylsalicylic acid 100 mg once daily (intervention) would be cost-effective compared to antithrombotic treatment with acetylsalicylic acid alone (comparator) in the comprehensive health economic evaluation setting. It was found that rivaroxaban was cost-effective and produced added value in the Finnish setting when used in addition to acetylsalicylic acid irrespective of the analyzed patient subgroup.

Link to the article: https://link.springer.com/article/10.1007/s12325-020-01398-8

More information: Erkki Soini