AHA: Rivaroxaban linked to fewer hospitalization days compared to warfarin in NVAF patients

Once-daily rivaroxaban (Xarelto, Janssen) is associated with significantly fewer hospitalization days and outpatient visits compared to warfarin in patients with nonvalvular atrial fibrillation (NVAF), according to data presented at the American Heart Association (AHA) 2014 Scientific Sessions in Chicago.

Corresponding hospitalization and outpatient healthcare costs were also significantly lower for rivaroxaban compared to warfarin in NVAF patients.

Rivaroxaban associated with lower inpatient costs compared to warfarin among NVAF patients

From May 2011 to December 2012, researchers analyzed medical and pharmacy healthcare claims from more than 4,500 patients in the Humana integrated claims database, which includes more than 11.3 million commercial and Medicare insurance members across the United States. The total number of hospitalization days, resource utilization (defined as hospitalizations, outpatient visits and emergency room [ER] visits), and healthcare costs including costs of the medicine, were reported.

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“This research provides insight into the value of [rivaroxaban], an alternative to the standard of care with the strongest access position of any novel oral anticoagulant,” said Concetta Crivera, PharmD, MPH, director, HECOR Cardiovascular, Janssen Scientific Affairs, LLC.

“For patients with commercial insurance using a copay card, [rivaroxaban] costs only $5 a month, similar to warfarin,” Dr Crivera said. “It is also broadly reimbursed, with 93 percent of patients on Medicare Part D and 92% of commercial patients covered at the lowest branded copay.”

Findings from the study suggest the cost burden associated with rivaroxaban for all-cause and NVAF-related hospitalization costs, as well as all-cause outpatient visit costs, was significantly lower than that associated with warfarin in patients with NVAF. Additionally, the mean all-cause and NVAF-related total of hospitalization days were significantly fewer for rivaroxaban compared to warfarin (2.71 vs. 3.87 days; 2.11 vs. 3.02 days). 

“As rising healthcare costs pose a concern for payers, providers and patients, we are continuing to progress our real-world data generation, investigating the value of [rivaroxaban], an important medicine that offers an alternative to the standard of care, without the need for routine blood monitoring and no known dietary restrictions,” Dr Crivera said.

When examining the cost and value of anticoagulant treatment more holistically in this study, including the cost of the medicine, the researchers observed the overall all-cause and NVAF-related costs remain comparable between rivaroxaban and warfarin. 

“This is due to the cost-savings from a reduced hospital length of stay for patients treated with [rivaroxaban] offsetting the price of the medicine,” Dr Crivera said.

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