OBJECTIVES: The aim of this study is to describe the economic impact of the dabigatran-specific reversal agent for patients with an acute disease or disorder requiring emergency surgery or urgent invasive intervention or in the event of life-threatening or uncontrolled bleeding. METHODS: This analysis is based on a two-round Delphi panel conducted among 8 anaesthesists and emergency physicians aimed to identify the changes of resources consumptions before and after the release of the dabigatran-specific reversal agent (idarucizumab) in France. Consumption of each resource (length of hospital stay, blood products, expensive drugs used etc.) was evaluated from two perspectives. On one hand, the hospital perspective for which a daily production cost has been estimated. On the other hand, a public payer perspective in which hospital stays have been covered with the French DRG tariffs. RESULTS: From the hospital perspective, the overall cost per patient with gastrointestinal bleedings and others bleedings is reduced of 35% when the reversal agent is used, mainly due to the decrease in length of stay and blood products use. In case of emergency surgery and in case of intracranial bleeding, the overall cost per patient remains relatively stable, with a decrease of 2% and a slight increase of 3% respectively. From the public payer perspective, costs are also diminished with a reduction of 35% in case of gastrointestinal bleedings and other bleedings and of 13% and 14% respectively for patient requiring emergency surgery and in case of intracranial bleedings CONCLUSIONS: The use of the dabigatran-specific reversal agent allows better care and considerable savings from a hospital perspective as well as from the public payer perspective.