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AuthorEljilany, Islam
AuthorElewa, Hazem
AuthorAbdelsamad, Osama
AuthorAbdelgelil, Mohamed
AuthorMahfouz, Ahmed
AuthorAnany, Rasha Al
AuthorYafei, Sumaya Al
AuthorAl-Badriyeh, Daoud
Available date2023-05-11T03:53:15Z
Publication Date2021-11-01
Publication NameCurrent Problems in Cardiology
Identifierhttp://dx.doi.org/10.1016/j.cpcardiol.2021.100839
ISSN01462806
URIhttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85107037661&origin=inward
URIhttp://hdl.handle.net/10576/42572
AbstractThe warfarin peri-procedural management in Qatar is predominantly based on bridging (63%), compared to non-bridging. This study sought to perform a first-time cost analysis of current warfarin peri-procedural management practices, including a cost-effectiveness analysis (CEA) of predominant bridging vs predominant non-bridging practices. From the hospital perspective, a one-year decision-analytic model followed the cost and success consequences of the peri-procedural warfarin in a hypothetical cohort of 10,000 atrial fibrillation patients. Success was defined as survival with no adverse events. Outcome measures were the cost and success consequences of the 63% bridging (vs not-bridging) practice in the study setting, ie, Hamad Medical Corporation, Qatar, and the incremental cost-effectiveness ratio (ICER, cost/success) of the warfarin therapy when predominantly bridging based vs when predominantly non-bridging based. The model was based on Monte Carlo simulation, and sensitivity analyses were performed to confirm the robustness of the study conclusions. As per 63% bridging practices, the mean overall cost of peri-procedural warfarin management per patient was USD 3,260 (QAR 11,900), associated with an overall success rate of 0.752. Based on the CEA, predominant bridging was dominant (lower cost, higher effect) over the predominant non-bridging practice in 62.2% of simulated cases, with a cost-saving of up to USD 2,001 (QAR 7,303) at an average of USD 272 (QAR 993) and was cost-effective in 36.9% of cases. Being between cost-saving and cost-effective, compared to predominant non-bridging practices, the predominant use of bridging with warfarin seems to be a favorable strategy in atrial fibrillation patients.
Languageen
PublisherElsevier
SubjectBridging vs Non-Bridging
Warfarin Peri-Procedural Management
TitleBridging vs Non-Bridging with Warfarin Peri-Procedural Management: Cost and Cost-Effectiveness Analyses
TypeArticle
Issue Number11
Volume Number46
dc.accessType Open Access


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