Pradaxa Worth It in Cases of Prior Strok

By Chris Kaiser, Cardiology Editor, MedPage Today: Published: February 08, 2012. Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

NEW ORLEANS — Dabigatran (Pradaxa) is more cost-effective than warfarin at preventing stroke in atrial fibrillation patients who have had a prior stroke or transient ischemic attack, a modeled analysis showed.

In the model, dabigatran provided 0.36 more quality-adjusted life-years (QALY) than warfarin, Hooman Kamel, MD, from Weill Cornell Medical College in New York City, and colleagues found.

The cost for those additional QALY was $9,000, translating into an incremental cost-effectiveness ratio of $25,000, Kamel reported at the American Stroke Association’s International Stroke Conference here and published online in Stroke: Journal of the American Heart Association.

The cost-effectiveness of dabigatran, a novel oral direct thrombin inhibitor, hinged on the control of the international normalized ratio (INR) with warfarin. Dabigatran had a greater advantage when there was poor INR control. Read Full Article