Figure 1.
Model for the non-valvular AF population.
Depicted in the diagram are the chance nodes (circles) and terminal nodes (triangles). Branches for apixaban and VKA are identical except numerical risks. Patients that discontinue the initial anticoagulant treatment re-enter the model with identical Markov branches but under the assumption of switching their treatment to acetylsalicylic acid. NVAF, non-valvular atrial fibrillation; ASA, acetylsalicylic acid; IS, ischemic stroke; HS, hemorrhagic stroke; SE, systemic embolism; MI, myocardial infarction; ICH, intracranial hemorrhage; CRNM, clinically-relevant non-major; MB, major bleeding; Tmt, treatment.
Table 1.
Baseline characteristics of the patients included in the model.
Table 2.
Stroke and other thromboembolic and bleeding complications and related costs within a hypothetical patient population of 1,000 subjects receiving apixaban and VKA over a lifetime horizon.
Table 3.
Incremental costs, QALYs and ICER for patients with non-valvular AF receiving anticoagulation therapy.
Figure 2.
Tornado diagram illustrating results from sensitivity analyses for apixaban vs. vitamin-K antagonists.
Black bars denote influence of the high value of the 95% confidence interval range and grey bars denote influence of the low value for parameters investigated. ICER, incremental cost-effectiveness ratio; QALY, quality adjusted life year; ICH, intracranial hemorrhage; AF, atrial fibrillation; MI, myocardial infarction; MB, major bleeding.
Figure 3.
Incremental cost-effectiveness plane.
Incremental cost-effectiveness plane presents the incremental cost-effectiveness ratios of apixaban compared to vitamin-K antagonists in patients with non-valvular atrial fibrillation, obtained through a probabilistic sensitivity analysis. Points below the diagonal dotted and the full line represent simulations in which apixaban was a cost-effective alternative at a threshold of €30,000/QALY and €20,000/QALY, respectively. QALY, quality adjusted life year; VKA, vitamin-K antagonists.
Figure 4.
Cost-effectiveness acceptability curves for the treatment with apixaban and VKA in non-valvular atrial fibrillation.
The cost-effectiveness acceptability curve assesses the probability that the estimated incremental cost-effectiveness ratio is under a certain willingness to pay threshold. VKA, vitamin-K antagonist; QALY, quality adjusted life year.
Table 4.
Scenario analyses on the impact of different levels of INR monitoring.