Economic burden of rivaroxaban and warfarin among nonvalvular atrial fibrillation patients with obesity and polypharmacy

J Comp Eff Res. 2021 Nov;10(16):1235-1250. doi: 10.2217/cer-2021-0150. Epub 2021 Aug 11.

Abstract

Aim: Evaluate healthcare resource utilization (HRU) and costs associated with rivaroxaban and warfarin among nonvalvular atrial fibrillation (NVAF) patients with obesity and polypharmacy. Materials & methods: IQVIA PharMetrics® Plus (January 2010-September 2019) data were used to identify NVAF patients with obesity (BMI ≥30 kg/m2) and polypharmacy (≥5 medications) initiated on rivaroxaban or warfarin. Weighted rate ratios and cost differences were evaluated post-treatment initiation. Results: Rivaroxaban was associated with significantly lower rates of HRU, including hospitalization (rate ratio [95% CI]: 0.83 [0.77, 0.92]). Medical costs were reduced in rivaroxaban users (difference [95% CI]: -US$6868 [-US$10,628, -US$2954]), resulting in significantly lower total healthcare costs compared with warfarin users (difference [95% CI]: -US$4433 [-US$8136, -US$582]). Conclusion: Rivaroxaban was associated with lower HRU and costs compared with warfarin among NVAF patients with obesity and polypharmacy in commercially insured US patients.

Keywords: healthcare; healthcare costs; nonvalvular atrial fibrillation; obesity; polypharmacy; resource utilization; rivaroxaban.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anticoagulants / therapeutic use
  • Atrial Fibrillation* / complications
  • Atrial Fibrillation* / drug therapy
  • Financial Stress
  • Humans
  • Obesity / complications
  • Obesity / drug therapy
  • Polypharmacy
  • Retrospective Studies
  • Rivaroxaban / therapeutic use
  • Stroke*
  • Warfarin / therapeutic use

Substances

  • Anticoagulants
  • Warfarin
  • Rivaroxaban