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    Healthcare Resource Utilization and Costs of Rivaroxaban Versus Warfarin Among Nonvalvular Atrial Fibrillation Patients with Obesity and Diabetes

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    Author
    Weir, Matthew R
    Chen, Yen-Wen
    He, Jinghua
    Bookhart, Brahim
    Campbell, Alicia
    Ashton, Veronica
    Date
    2021-10-26
    Journal
    Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders
    Publisher
    Springer Nature
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1007/s13300-021-01161-4
    http://www.ncbi.nlm.nih.gov/pmc/articles/pmc8586051/
    Abstract
    Introduction: Nonvalvular atrial fibrillation (NVAF) is associated with a substantial economic burden, particularly in patients with comorbid conditions. This study compared healthcare resource utilization (HRU) and costs of rivaroxaban and warfarin in patients with NVAF, obesity, and diabetes. Methods: A de-identified healthcare claims database was used to identify adult patients newly initiating rivaroxaban or warfarin and having at least one medical claim with a diagnosis of AF, obesity determined by validated algorithm, and at least one claim with a diagnosis of diabetes or for antidiabetic medication from December 2011 to March 2020. Propensity score matching was used to balance the treatment cohorts on the basis of demographics and baseline characteristics. All-cause and NVAF-related HRU rates and costs were compared between treatments using rate ratios, and mean cost differences were calculated on a per patient per year (PPPY) basis. Results: A total of 9999 matched pairs of patients with NVAF, obesity, and diabetes were identified in the rivaroxaban and warfarin cohorts. Rate ratios of all-cause HRU were significantly reduced with rivaroxaban versus warfarin in all healthcare settings evaluated, except emergency room visits. The greatest impact was on physician office visits followed by hospital outpatient and inpatient visits. NVAF-related HRU was significantly lower for rivaroxaban versus warfarin in all care settings. Consistent with these findings, the length of hospital stay was significantly reduced by approximately 4 days among all patients for both all-cause and NVAF-related hospitalizations in the rivaroxaban cohort compared with the warfarin cohort. Rivaroxaban was associated with reductions in all-cause total healthcare costs by more than $5000 PPPY and NVAF-related medical costs by approximately $1100 PPPY. Conclusion: In comparison with warfarin, rivaroxaban reduced HRU and costs, particularly hospital inpatient and outpatient visits and physician office visits, in patients with NVAF and comorbidities of obesity and diabetes.
    Rights/Terms
    © 2021. The Author(s).
    Keyword
    Anticoagulation
    Costs
    Diabetes mellitus
    Healthcare resource utilization
    Nonvalvular atrial fibrillation
    Obesity
    Real-world evidence
    Rivaroxaban
    Warfarin
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/17160
    ae974a485f413a2113503eed53cd6c53
    10.1007/s13300-021-01161-4
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