OBJECTIVES: The aim of the study was to compare economic costs associated with apixaban vs warfarin in patients with nonvalvular atrial fibrillation (NVAF) using Japanese claims database provided by Medical Data Vision Co., Ltd.

METHODS: A retrospective cohort study was conducted using de-identified claims data from 275 institutions provided by Medical Data Vision. Adult NVAF patients newly initiated on oral anticoagulants (OAC) from 1 March 2011 to 31 March 2016 were eligible. Based on the first(index) OAC prescription, patients were assigned to apixaban or warfarin groups, and cohorts were matched using propensity score. Per patient cumulative 12 months medical cost and healthcare resource use were compared for the patients who has the follow up period of at least 12 months after the index date.

RESULTS: After propensity score matching, there were 1,752 warfarin-apixaban matched patients. Compared to warfarin, apixaban were associated with a significantly lower total cost(warfarin: 1,619,418 yen, apixaban: 1,337,258 yen, difference: -282,160 yen per year, p<0.001) in spite of higher OAC cost (warfarin: 15,843 yen, apixaban: 100,113 yen, difference: 84,270 yen per year, p<0.001). Of the total cost, the cost of hospitalization was significantly lower for apixaban versus warfarin(warfarin: 1,228,532 yen, apixaban: 926,183 yen, difference: -302,350 yen per year, p<0.001) with lower total length of stay (warfarin:24.3 day, apixaban:15.5 day, difference: -8.8 day per year, p<0.001).

CONCLUSIONS: NVAF patients newly treated with apixaban had lower total medical costs and healthcare resource use compared with those treated with warfarin.