Study Finds Xarelto With Aspirin Reduced Direct Atherosclerotic Disease Costs

Data from the COMPASS trial, presented at the AHA 2017 Scientific Sessions, found that a regimen of Xarelto (rivaroxaban; Janssen) with 100 mg of aspirin reduced hospitalization, and health services costs among patients with stable atherosclerotic vascular disease.

“Aspirin reduces the risk of myocardial infarction (MI), stroke, or cardiovascular disease (CVD) death in those with vascular disease by about 20% compared with placebo and is the standard of practice,” Andre Lamy, MD, MHSc, professor of surgery at McMaster University in Canada, and colleagues wrote. “Addition of a vitamin K antagonist to aspirin reduces vascular events by a further 20% in patients with coronary artery disease (CAD), but increases bleeding... 2- to 3-fold. COMPASS evaluates whether Xarelto 5 mg twice-daily, or Xarelto 2.5 mg twice-daily in combination with aspirin 100 mg daily, is superior to aspirin 100 mg daily for prevention of MI stroke, or CVD death in patients with stable CAD or peripheral vascular disease.” 

The COMPASS trial studied 27,395 patients from 602 facilities in 33 countries from between 2013 and 2016. The Xarelto/aspirin arms of the study were discontinued in February 2017, as they demonstrated clear clinical benefit. The researchers further studied the data to report the cost impact of a Xarelto/aspirin regimen. 

The researchers found that both total event costs and total procedure costs were reduced by $4,180,325 and $1,963,984, respectively. The most significant cost impact of the Xarelto/aspirin regimen was for stroke-related costs, which were reduced by $3,664,425.

“The final results of this economic analysis of the COMPASS will inform the economic impact of [Xarelto] in combination with aspirin, compared to aspirin alone in secondary prevention,” Dr Lamy and colleagues concluded.

—David Costill