Bridging vs Non-Bridging with Warfarin Peri-Procedural Management: Cost and Cost-Effectiveness Analyses

<p dir="ltr">The warfarin peri-procedural management in Qatar is predominantly based on bridging (63%), compared to non-bridging. This study sought to perform a first-time cost analysis of current warfarin peri-procedural management practices, including a cost-effectiveness analysis...

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Main Author: Islam Eljilany (14151588) (author)
Other Authors: Hazem Elewa (3592601) (author), Osama Abdelsamad (14151600) (author), Mohamed Abdelgelil (16515261) (author), Ahmed Mahfouz (737928) (author), Rasha Al Anany (17302822) (author), Sumaya Al Yafei (17302825) (author), Daoud Al-Badriyeh (832403) (author)
Published: 2021
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author Islam Eljilany (14151588)
author2 Hazem Elewa (3592601)
Osama Abdelsamad (14151600)
Mohamed Abdelgelil (16515261)
Ahmed Mahfouz (737928)
Rasha Al Anany (17302822)
Sumaya Al Yafei (17302825)
Daoud Al-Badriyeh (832403)
author2_role author
author
author
author
author
author
author
author_facet Islam Eljilany (14151588)
Hazem Elewa (3592601)
Osama Abdelsamad (14151600)
Mohamed Abdelgelil (16515261)
Ahmed Mahfouz (737928)
Rasha Al Anany (17302822)
Sumaya Al Yafei (17302825)
Daoud Al-Badriyeh (832403)
author_role author
dc.creator.none.fl_str_mv Islam Eljilany (14151588)
Hazem Elewa (3592601)
Osama Abdelsamad (14151600)
Mohamed Abdelgelil (16515261)
Ahmed Mahfouz (737928)
Rasha Al Anany (17302822)
Sumaya Al Yafei (17302825)
Daoud Al-Badriyeh (832403)
dc.date.none.fl_str_mv 2021-11-01T09:00:00Z
dc.identifier.none.fl_str_mv 10.1016/j.cpcardiol.2021.100839
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Bridging_vs_Non-Bridging_with_Warfarin_Peri-Procedural_Management_Cost_and_Cost-Effectiveness_Analyses/24459124
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Cardiovascular medicine and haematology
Clinical sciences
Pharmacology and pharmaceutical sciences
Economics
Econometrics
Bridging
Non-Bridging
Cost-Effectiveness Analyses
Warfarin Peri-Procedural Management
dc.title.none.fl_str_mv Bridging vs Non-Bridging with Warfarin Peri-Procedural Management: Cost and Cost-Effectiveness Analyses
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <p dir="ltr">The warfarin peri-procedural management in Qatar is predominantly based on bridging (63%), compared to non-bridging. This study sought to perform a first-time cost analysis of current warfarin peri-procedural management practices, including a cost-effectiveness analysis (CEA) of predominant bridging vs predominant non-bridging practices. From the hospital perspective, a one-year decision-analytic model followed the cost and success consequences of the peri-procedural warfarin in a hypothetical cohort of 10,000 atrial fibrillation patients. Success was defined as survival with no adverse events. Outcome measures were the cost and success consequences of the 63% bridging (vs not-bridging) practice in the study setting, ie, Hamad Medical Corporation, Qatar, and the incremental cost-effectiveness ratio (ICER, cost/success) of the warfarin therapy when predominantly bridging based vs when predominantly non-bridging based. The model was based on Monte Carlo simulation, and sensitivity analyses were performed to confirm the robustness of the study conclusions. As per 63% bridging practices, the mean overall cost of peri-procedural warfarin management per patient was USD 3,260 (QAR 11,900), associated with an overall success rate of 0.752. Based on the CEA, predominant bridging was dominant (lower cost, higher effect) over the predominant non-bridging practice in 62.2% of simulated cases, with a cost-saving of up to USD 2,001 (QAR 7,303) at an average of USD 272 (QAR 993) and was cost-effective in 36.9% of cases. Being between cost-saving and cost-effective, compared to predominant non-bridging practices, the predominant use of bridging with warfarin seems to be a favorable strategy in atrial fibrillation patients.</p><h2>Other Information</h2><p dir="ltr">Published in: Current Problems in Cardiology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.cpcardiol.2021.100839" target="_blank">https://dx.doi.org/10.1016/j.cpcardiol.2021.100839</a></p>
eu_rights_str_mv openAccess
id Manara2_42c089999fc90dead0574842f049c1b9
identifier_str_mv 10.1016/j.cpcardiol.2021.100839
network_acronym_str Manara2
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oai_identifier_str oai:figshare.com:article/24459124
publishDate 2021
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spelling Bridging vs Non-Bridging with Warfarin Peri-Procedural Management: Cost and Cost-Effectiveness AnalysesIslam Eljilany (14151588)Hazem Elewa (3592601)Osama Abdelsamad (14151600)Mohamed Abdelgelil (16515261)Ahmed Mahfouz (737928)Rasha Al Anany (17302822)Sumaya Al Yafei (17302825)Daoud Al-Badriyeh (832403)Biomedical and clinical sciencesCardiovascular medicine and haematologyClinical sciencesPharmacology and pharmaceutical sciencesEconomicsEconometricsBridgingNon-BridgingCost-Effectiveness AnalysesWarfarin Peri-Procedural Management<p dir="ltr">The warfarin peri-procedural management in Qatar is predominantly based on bridging (63%), compared to non-bridging. This study sought to perform a first-time cost analysis of current warfarin peri-procedural management practices, including a cost-effectiveness analysis (CEA) of predominant bridging vs predominant non-bridging practices. From the hospital perspective, a one-year decision-analytic model followed the cost and success consequences of the peri-procedural warfarin in a hypothetical cohort of 10,000 atrial fibrillation patients. Success was defined as survival with no adverse events. Outcome measures were the cost and success consequences of the 63% bridging (vs not-bridging) practice in the study setting, ie, Hamad Medical Corporation, Qatar, and the incremental cost-effectiveness ratio (ICER, cost/success) of the warfarin therapy when predominantly bridging based vs when predominantly non-bridging based. The model was based on Monte Carlo simulation, and sensitivity analyses were performed to confirm the robustness of the study conclusions. As per 63% bridging practices, the mean overall cost of peri-procedural warfarin management per patient was USD 3,260 (QAR 11,900), associated with an overall success rate of 0.752. Based on the CEA, predominant bridging was dominant (lower cost, higher effect) over the predominant non-bridging practice in 62.2% of simulated cases, with a cost-saving of up to USD 2,001 (QAR 7,303) at an average of USD 272 (QAR 993) and was cost-effective in 36.9% of cases. Being between cost-saving and cost-effective, compared to predominant non-bridging practices, the predominant use of bridging with warfarin seems to be a favorable strategy in atrial fibrillation patients.</p><h2>Other Information</h2><p dir="ltr">Published in: Current Problems in Cardiology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.cpcardiol.2021.100839" target="_blank">https://dx.doi.org/10.1016/j.cpcardiol.2021.100839</a></p>2021-11-01T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.cpcardiol.2021.100839https://figshare.com/articles/journal_contribution/Bridging_vs_Non-Bridging_with_Warfarin_Peri-Procedural_Management_Cost_and_Cost-Effectiveness_Analyses/24459124CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/244591242021-11-01T09:00:00Z
spellingShingle Bridging vs Non-Bridging with Warfarin Peri-Procedural Management: Cost and Cost-Effectiveness Analyses
Islam Eljilany (14151588)
Biomedical and clinical sciences
Cardiovascular medicine and haematology
Clinical sciences
Pharmacology and pharmaceutical sciences
Economics
Econometrics
Bridging
Non-Bridging
Cost-Effectiveness Analyses
Warfarin Peri-Procedural Management
status_str publishedVersion
title Bridging vs Non-Bridging with Warfarin Peri-Procedural Management: Cost and Cost-Effectiveness Analyses
title_full Bridging vs Non-Bridging with Warfarin Peri-Procedural Management: Cost and Cost-Effectiveness Analyses
title_fullStr Bridging vs Non-Bridging with Warfarin Peri-Procedural Management: Cost and Cost-Effectiveness Analyses
title_full_unstemmed Bridging vs Non-Bridging with Warfarin Peri-Procedural Management: Cost and Cost-Effectiveness Analyses
title_short Bridging vs Non-Bridging with Warfarin Peri-Procedural Management: Cost and Cost-Effectiveness Analyses
title_sort Bridging vs Non-Bridging with Warfarin Peri-Procedural Management: Cost and Cost-Effectiveness Analyses
topic Biomedical and clinical sciences
Cardiovascular medicine and haematology
Clinical sciences
Pharmacology and pharmaceutical sciences
Economics
Econometrics
Bridging
Non-Bridging
Cost-Effectiveness Analyses
Warfarin Peri-Procedural Management