OBJECTIVES : Atrial fibrillation (AF) remains as one of the diseases with highest burden for public system. The objective of this work is to estimate the budget impact of Dabigatran versus vitamin K antagonists in patients with AF and labile international normalized ratio (INR), from the specific perspective of the Hospital Regional de Concepción, Chile

METHODS : A 5-year time horizon was used to estimate cost of drugs, disease management, clinical consequences, and treatment related adverse events. Costs were estimated using absorption cost method (A method to build up total production cost including indirect and overhead costs through an absorption rate). Effect of Dabigatran in disease management, clinical consequences and adverse event were estimated directly from results of pivotal trial

RESULTS : The expect cost in USD (1 USD = 750 CLP) to treat a labile INR patient with Dabigatran is USD 2,960 per patient/year and with vitamin K antagonist is USD 3,163 per patient/year, saving USD 203 per patient/year. Applying to the prevalent population of the Hospital, the savings per year to the hospital are estimated in USD 681,624. The use of Dabigatran leads to less resource use that can be translated in a reduction of 50 urgency visits per year, 370 GP visits per year, 20 surgeries per year and 200 inpatient day per year in a prevalent population of 3,300 people with labile INR

CONCLUSIONS : Using Dabigatran to treat AF labile INR patients saves resources in comparison to treat them with standard vitamin K antagonists