OBJECTIVES

Atrial fibrillation (AFib or AF) is a quivering or irregular heartbeat (arrhythmia) that can lead to blood clots, stroke, heart failure and other heart-related complications. The prevalence of AF is increasing and a major global health burden worldwide. This systematic review’s objective is to build an overview of the economic evaluation of apixaban in treatment of atrial fibrillation.

METHODS

A systematic review was conducted by searching articles published up to present from electronic databases including Medline and Cochrane with statement as “((apixaban) AND (economic evaluation [MeSH Terms])) AND (atrial fibrillation[MeSH Terms])”. This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement. Studying characteristics, incremental cost-effectiveness ratio (ICER) are extracted. The analysis’s quality will be assessed by Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklists. All costs are converted into 2020 USD by using consumer price index (CPI) from database of World Bank.

RESULTS

There were 16 out of 76 studies found satisfying inclusion and exclusion criteria. All the 16 studies included in the system demonstrated incremental cost per quality-adjusted life-year gained of apixaban versus other drugs in the majority perspective of healthcare system. Results showed that apixaban therapy for patients with atrial fibrillation was cost-effective compared with others (warfarin, aspirin,...). ICERs recorded from included studies were all lower than willingness-to-pay (WTP) and ranged from 3,772.84 to 58,762.02 USD. An independent assessment of articles based on CHEERS checklist showed the number of sections or items of the studies achieving ranged from 21 to 23 out of 24 items.

CONCLUSIONS

This review demonstrated that apixaban is likely to be a cost-effective alternative to other drugs for stroke prophylaxis in patients with AF. New researches are published every year. Thus, system reviews should be conducted constantly with more expanding scale to provide a comprehensive perspective.