Published Oct 3, 2014

Cairo, Egypt - Most patients undergoing aortic valve replacement currently receive anticoagulant therapy to prevent thromboembolic events. The addition of an anti-platelet drug to anticoagulant therapy significantly reduces the rate of thromboembolism and valve thrombosis. The initiation of an effective early antithrombotic therapy is important because of its potential effect on the rate of early thromboembolic complications after mechanical aortic heart valve implantation, however, the cost-effectiveness of combining the use of warfarin and low-dose aspirin versus warfarin alone has not yet been established in Egypt. Researchers from the Pharmacoeconomic Unit at Central Administration for Pharmaceutical Affairs and the Faculty of Pharmacy at Ain Shams University in Egypt compared the cost-effectiveness of using combined therapy versus warfarin alone in aortic valve replacements from a medical provider perspective. The results of the study showed that the total quality-adjusted life-years (QALYs) were estimated to be 1.1616 and 1.1199 for the warfarin plus aspirin group and the warfarin group, respectively. The total cost for the warfarin plus aspirin group and the warfarin group was US $307.33 and US $315.25, respectively, which yielded an incremental cost-effectiveness ratio of -190.38 for the warfarin plus aspirin group. Thus, the combined therapy is more effective and less costly than using warfarin alone. "For clinicians and patients who choose to focus on minimizing thromboembolic risk in aortic valve replacement, these results suggest that combined therapy offers the best protection and reduced cost because antithrombotic treatment improves the quality of patient care and reduces the overall cost. In order to convince clinicians to take action on the appropriate prevention therapy of thromboembolic events, they need strong evidence-based research on the most cost-effective therapy." says Dr. Gihan Hamdy Elsisi, MSc, Head of Pharmacoeconomic Unit at Central Administration for Pharmaceutical Affairs, Ministry of Health in Cairo, Egypt. The full study, “Cost-Effectiveness of the Combined Use of Warfarin and Low-Dose Aspirin versus Warfarin Alone in Egyptian Patients with Aortic Valve Replacements: A Markov Model,” is published in Value in Health Regional Issues.