A new alternative to coumadin may be coming…

For those that take coumadin, especially for stroke prevention in atrial fibrillation, the “hassle factor” is a significant issue.  The need for regular monitoring and lability of effect especially when diet and or medications change make this medication harder to use.  In October 2010 the FDA approved a new medication that can be taken without some of these hassle factors.  A previous similar medication was pulled from the market due to liver toxicity.  This new medication is supposed to be safer but its cost may be high.  Time will tell if it becomes useful.  The attached quote is a summary statement from the Annals of IM article.  “In conclusion, we found that treatment with dabigatran could be a cost-effective alternative to adjusted-dose warfarin for stroke prevention in patients older than 65 years with nonvalvular AF at increased risk for stroke (CHADS2 score ≥1 or equivalent). High-dose dabigatran was the most cost-effective and most effective therapy we evaluated, providing an additional 0.56 QALY over warfarin in our base-case analysis. For patients at higher risk for ischemic stroke and ICH, the ICER of dabigatran compared with warfarin improved. These results were robust over a wide range of model assumptions but were sensitive to dabigatran costs.”


One Comment Add yours

  1. The new alternative is here. Dabigatran is on the market and another option for anticoagulation especially for stroke protection in atrial fibrillation as a more convenient option to coumadin (fixed dosing and no coumadin clinic monitoring).

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