Warfarin Patients Incurred Higher Post-Stroke Care Costs Compared with Rivaroxaban

Researchers presented data comparing total healthcare cost in pre- and post-stroke periods between rivaroxaban- and warfarin-treated non-valvular atrial fibrillation NVAF patients.at the International Stroke Conference 2020.

The researchers study results showed substantial increase in total cost of care following stroke, especially among patients with severe strokes, according to the abstract published in Stroke. 

The retrospective study used deidentified patient data from the IBM MarketScan Commercial and Medicare databases from 2011 to 2019. Eligible patients included those who initiated rivaroxaban or warfarin within 30 days of their first observed NVAF diagnosis, who later developed ischemic or hemorrhage stroke. 

Each patient had at least or more than 6 months of continue health plan enrollment CHA2DS2-VASc score ≥2 and no history of stroke or anticoagulation therapy.

Total per-patient per-year cost of care was calculated from time of diagnosis to 25 and 30 months post stroke. Cost increases pre-/post-stroke were compared within each treatment cohort.

“During a mean follow up of 25 and 30 months for rivaroxaban and warfarin respectively, 272 (2.0%) and 1,303 (3.3%) patients, respectively, developed stroke,” stated the researchers. “For the rivaroxaban cohort, the pre-/post-stroke cost increase was lower than that for warfarin (1.79-fold vs 3.08-fold, respectively); for more severe stroke (NIHSS ≥6), the cost increase for rivaroxaban was half that of warfarin (3.19-fold increase vs 6.37-fold increase, respectively).”

Results of the study would suggest that rivaroxaban is associated with preventing strokes with both costly and poor outcomes, when compared with warfarin. —Edan Stanley