{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T20:27:45Z","timestamp":1783542465213,"version":"3.55.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,1,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The economic burden of nonvalvular atrial fibrillation (NVAF) is substantial. Many patients with NVAF are obese and manage other health conditions requiring multiple medications. This real\u2010world study compared health care resource use (HRU) and costs for rivaroxaban and warfarin in patients with NVAF who had polypharmacy and obesity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">We used health care claims databases (Merative MarketScan commercial and Medicare supplemental claims) to identify patients initiating the direct oral anticoagulant rivaroxaban or warfarin with \u22651 diagnostic claim for atrial fibrillation, presence of polypharmacy (based on 3 categories for the number of concurrent medications: 1\u20134, 5\u20139, \u226510), and obesity. Cohorts were balanced for demographic and baseline characteristics using propensity score matching. All\u2010cause and NVAF\u2010related HRU rates and costs were compared between treatments using rate ratios and adjusted mean differences per patient per year. Eligible patients totaled 95\u2009875, with 19\u2009990 patients in each treatment cohort following propensity score matching. All\u2010cause HRU rates were significantly lower with rivaroxaban versus warfarin, and hospital stays were reduced by 3.1\u2009days with rivaroxaban. Mean (95% CI) all\u2010cause total medical and total health care costs per patient per year were significantly reduced with rivaroxaban versus warfarin (\u2212$4499 [\u2212$5660 to \u2212$3305] and \u2013$1627 [\u2212$2790 to \u2212$438], respectively). NVAF\u2010related HRU was reduced with rivaroxaban versus warfarin, but total NVAF\u2010related medical costs were not significantly different between treatment groups ($144 [\u2212$756 to $1079] per patient per year). Subgroup and sensitivity analysis results were generally consistent with the main analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Among patients with NVAF, polypharmacy, and obesity, rivaroxaban was associated with a reduction in HRU and all\u2010cause costs compared with warfarin.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.036401","type":"journal-article","created":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T11:18:44Z","timestamp":1736507924000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Health Care Resource Use and Costs of Rivaroxaban Versus Warfarin Among Nonvalvular Atrial Fibrillation Polypharmacy Patients With Obesity"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5488-6810","authenticated-orcid":false,"given":"Mark","family":"Alberts","sequence":"first","affiliation":[{"name":"Hartford HealthCare Hartford CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinghua","family":"He","sequence":"additional","affiliation":[{"name":"Janssen Scientific Affairs LLC, a Johnson &amp; Johnson company Titusville NJ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1056-9466","authenticated-orcid":false,"given":"Akshay","family":"Kharat","sequence":"additional","affiliation":[{"name":"Janssen Scientific Affairs LLC, a Johnson &amp; Johnson company Titusville NJ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1394-6375","authenticated-orcid":false,"given":"Christopher D.","family":"Pericone","sequence":"additional","affiliation":[{"name":"Janssen Research &amp; Development LLC, a Johnson &amp; Johnson company Raritan NJ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4880-1897","authenticated-orcid":false,"given":"Veronica","family":"Ashton","sequence":"additional","affiliation":[{"name":"Janssen Scientific Affairs LLC, a Johnson &amp; Johnson company Titusville NJ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2011.10.026"},{"key":"e_1_3_2_3_2","first-page":"1","article-title":"Prevalence of obesity and severe obesity among adults: United States, 2017\u20132018","volume":"360","author":"Hales CM","year":"2020","unstructured":"Hales CM, Carroll MD, Fryar CD, Ogden CL. 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