The Clinical Evaluation Of Warfarin And Its Pharmacoeconomic Evaluation With Rivaroxaban

Purpose: Understand the actual clinical use of warfarin in hospitalized patients with non-valvular atrial fibrillation,and conduct clinical evaluation of effectiveness and safety;conduct pharmacoeconomic evaluation of warfarin and rivaroxaban to explore which drugs The economic advantages of patients with non-valvular atrial fibrillation in my country provide a reference for clinical drug selection.Methods: 1.Screen the medical records of patients diagnosed with non-valvular atrial fibrillation from January 2016 to June 2020 who used warfarin during hospitalization for ≥ 4 days,and analyze the effectiveness and safety,and pass the analysis between groups,Single-factor and multi-factor regression analysis to explore the factors that affect the efficacy of warfarin.2.Use the Markov model to evaluate the pharmacoeconomics of warfarin and rivaroxaban,and plan to introduce the possible outcomes of patients with non-valvular atrial fibrillation taking warfarin or rivaroxaban in China after 20 years And costs.Results: 1.There are a total of 178 medical records of patients included in this study,including 87 males and 91 females.The age range is 26 to 87 years.The average age of the patients is 69.88±10.41 years.The average duration of medication is8.26±3.58 days.The average hospitalization is The duration is 10.10±4.36 days;2.The initial dose of warfarin was 2.5 mg,with 109 patients,accounting for 61.2%;59 patients reached the target INR value at discharge,accounting for 33.2%;stroke risk score and warfarin dose And wireless sexual relations.3.A total of 8 cases of bleeding occurred,with a bleeding rate of 0.05%,4 males and 4 females,and only 1 case still bleeds after taking countermeasures.4.When the patient is between 50 and 60,β<0 and OR<1,while the high-dose patients have β<0 and OR<1.When the patients are not combined with heparin,β<0and OR<1.5.Rivaroxaban received 15.95 QALYs,warfarin received 15.01 QALYs,warfarin only cost 5670.62 yuan,and rivaroxaban cost 118871.66 yuan,and the ICER of the two treatment options was 121032.65.6.The sensitivity analysis results are consistent with the model baseline analysis.Conclusion: 1.In this study,warfarin has better curative effect in hospitalized patients with non-valvular atrial fibrillation;among the factors that affect the curative effect of warfarin,patients in the age range of 50-60 years have less curative effect than those in 50 years old.The patient is good;combined use of heparin is a favorable factor for the efficacy of warfarin.2.The qualified rate of in-hospital monitoring frequency of INR value is 100%,all are minor bleeding,and bleeding is stopped after taking measures such as discontinuation,dose reduction,and dressing change.There are no other adverse reactions.The clinical application of warfarin is generally reasonable.3.There is no statistical relationship between the patient’s stroke risk score and the dose of warfarin and the INR value,and it cannot provide an accurate reference dose for patients who cannot monitor the INR value.4.ICER is 121032.65 yuan <WTP(217113 yuan).Rivaroxaban has an economic advantage over warfarin.Sensitivity analysis shows that the model results are stable.