{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T04:24:30Z","timestamp":1790483070587,"version":"4.1.0"},"reference-count":118,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Atrial fibrillation (AF) is a common clinical arrhythmia, primarily associated with the risk of stroke and various thromboembolic events, imposing significant clinical and economic burdens on patients and societies. This study aimed to review the relevant pharmacoeconomic evaluations of novel oral anticoagulants (NOACs) compared to vitamin K antagonists (VKAs) in patients with AF and explore the influencing factors and general trends of economic evaluations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This review qualitatively analyzed the basic characteristics, model structure, and basic results of all included studies. Moreover, a cross-sectional and longitudinal comparative analysis of costs, health outcomes, and cost-effectiveness results of studies in the United States, China, and the United Kingdom was conducted. Additionally, this study employed multivariate binary logistic regression to explore the influencing factors and general trends of the cost-effectiveness between NOACs and VKAs across all included studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 103 studies were included, comprising 218 comparisons between NOACs and VKAs. Total costs and health outcomes measured in studies with different countries and baseline characteristics exhibited considerable variations. However, NOACs generally had higher total costs than VKAs and resulted in more health outcomes for patients. The binary logistic regression analysis revealed that the country\u2019s economic development level, study perspective, and cycle length significantly influenced cost-effectiveness results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In high-income countries, NOACs are generally considered cost-effective, while VKAs may remain an attractive strategy in middle- and low-income countries. Additionally, factors such as drug prices, patient baseline characteristics, and model settings could impact the costs, health outcomes, and cost-effectiveness results of studies. Conducting relevant pharmacoeconomic research based on specific populations and study contexts is essential.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphar.2025.1441754","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T09:01:05Z","timestamp":1743152465000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Factors influencing the cost-effectiveness of novel oral anticoagulants compared to vitamin K antagonists in patients with atrial fibrillation: a systematic review"],"prefix":"10.3389","volume":"16","author":[{"given":"Yan","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xintian","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aixia","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pingyu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongchao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1177\/2047487313514019","article-title":"Cost-effectiveness of apixaban compared to warfarin in the management of atrial fibrillation in Australia","volume":"22","author":"Ademi","year":"2015","journal-title":"Eur. J. Prev. Cardiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"e022320","DOI":"10.1136\/bmjopen-2018-022320","article-title":"Atrial fibrillation among adults with heart failure in sub-Saharan Africa-prevalence, incidence and all-cause mortality: a systematic review and meta-analysis protocol","volume":"9","author":"Agbor","year":"2019","journal-title":"BMJ Open"},{"key":"B3","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.vhri.2022.04.007","article-title":"Cost-utility analysis of dabigatran and warfarin for stroke prevention among patients with nonvalvular atrial fibrillation in India","volume":"31","author":"Aghoram","year":"2022","journal-title":"Value Health Reg. Issues"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1016\/j.jval.2018.06.009","article-title":"Cost-utility analysis of apixaban versus warfarin in atrial fibrillation patients with chronic kidney disease","volume":"21","author":"Altawalbeh","year":"2018","journal-title":"Value Health"},{"key":"B5","first-page":"289","article-title":"Economic evaluation of dabigatran etexilate in the management of atrial fibrillation in Greece","volume":"54","author":"Andrikopoulos","year":"2013","journal-title":"Hell. J. Cardiol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1007\/s40256-016-0204-1","article-title":"Cost effectiveness of apixaban versus warfarin or aspirin for stroke prevention in patients with atrial fibrillation: a Greek perspective","volume":"17","author":"Athanasakis","year":"2017","journal-title":"Am. J. Cardiovasc Drug"},{"key":"B7","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1016\/j.rec.2014.08.010","article-title":"Cost-effectiveness analysis comparing apixaban and acenocoumarol in the prevention of stroke in patients with nonvalvular atrial fibrillation in Spain","volume":"68","author":"Bar\u00f3n","year":"2015","journal-title":"Rev. Espa\u00f1ola Cardiol. English Ed."},{"key":"B8","doi-asserted-by":"publisher","first-page":"e0225301","DOI":"10.1371\/journal.pone.0225301","article-title":"Real-world cost-effectiveness of rivaroxaban compared with vitamin K antagonists in the context of stroke prevention in atrial fibrillation in France","volume":"15","author":"Bowrin","year":"","journal-title":"Plos One"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1782164","DOI":"10.1080\/20016689.2020.1782164","article-title":"Real-world cost-effectiveness of rivaroxaban and apixaban vs VKA in stroke prevention in non-valvular atrial fibrillation in the UK","volume":"8","author":"Bowrin","year":"","journal-title":"J. Mark. Access Health Policy"},{"key":"B10","doi-asserted-by":"publisher","first-page":"2369","DOI":"10.1093\/eurheartj\/ehq278","article-title":"Guidelines for the management of atrial fibrillation: the task force for the management of atrial fibrillation of the European society of cardiology (ESC)","volume":"31","author":"Camm","year":"2010","journal-title":"Eur. Heart J."},{"key":"B11","doi-asserted-by":"publisher","first-page":"724","DOI":"10.1161\/CIRCOUTCOMES.113.000661","article-title":"Cost-effectiveness of oral anticoagulants for treatment of atrial fibrillation","volume":"6","author":"Canestaro","year":"2013","journal-title":"Circ. Cardiovasc Qual. Outcomes"},{"key":"B12","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1186\/s12913-015-0934-9","article-title":"Cost-effectiveness analysis of dabigatran and anticoagulation monitoring strategies of vitamin K antagonist","volume":"15","author":"Carles","year":"2015","journal-title":"Bmc Health Serv. Res."},{"key":"B13","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1016\/j.thromres.2014.02.024","article-title":"Cost-effectiveness of dabigatran etexilate for the prevention of stroke and systemic embolism in atrial fibrillation in Taiwan","volume":"133","author":"Chang","year":"2014","journal-title":"Thromb. Res."},{"key":"B14","first-page":"1216","article-title":"Economic evaluation of dabigatran, rivaroxaban and warfarin in preventing stroke in patients with atrial fibrillation","volume":"25","author":"Chen","year":"2016","journal-title":"Chin. J. New Drugs"},{"key":"B15","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1016\/j.acvd.2014.04.009","article-title":"Cost-effectiveness of dabigatran versus vitamin K antagonists for the prevention of stroke in patients with atrial fibrillation: a French payer perspective","volume":"107","author":"Chevalier","year":"2014","journal-title":"Arch. Cardiovasc Dis."},{"key":"B16","doi-asserted-by":"publisher","first-page":"849474","DOI":"10.3389\/fcvm.2022.849474","article-title":"Cost-effectiveness of direct oral anticoagulant vs. warfarin among atrial fibrillation patients with intermediate stroke risk","volume":"9","author":"Choi","year":"2022","journal-title":"Front. Cardiovasc Med."},{"key":"B17","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1016\/j.amjcard.2014.06.015","article-title":"Efficacy and cost-effectiveness of dabigatran etexilate versus warfarin in atrial fibrillation in different age subgroups","volume":"114","author":"Clemens","year":"2014","journal-title":"Am. J. Cardiol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1139","DOI":"10.1056\/NEJMoa0905561","article-title":"Dabigatran versus warfarin in patients with atrial fibrillation","volume":"361","author":"Connolly","year":"2009","journal-title":"New Engl. J. Med."},{"key":"B19","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1016\/j.jval.2013.01.009","article-title":"Cost-effectiveness of new oral anticoagulants compared with warfarin in preventing stroke and other cardiovascular events in patients with atrial fibrillation","volume":"16","author":"Coyle","year":"2013","journal-title":"Value Health"},{"key":"B20","doi-asserted-by":"publisher","first-page":"63","DOI":"10.3969\/j.issn.1672-3384.2020.12.013","article-title":"Oral anticoagulants for stroke prevention in atrial fibrillation:a cost-effectiveness analysis under different medical insurances in China","volume":"18","author":"Cui","year":"2020","journal-title":"Clin. Medicat. J."},{"key":"B21","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1093\/eurheartj\/ehs157","article-title":"Cost-effectiveness of dabigatran compared with warfarin for patients with atrial fibrillation in Sweden","volume":"34","author":"Davidson","year":"2013","journal-title":"Eur. Heart J."},{"key":"B22","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1007\/s40273-020-00908-4","article-title":"Health economic models for metastatic colorectal cancer: a methodological review","volume":"38","author":"Degeling","year":"2020","journal-title":"Pharmacoeconomics"},{"key":"B23","doi-asserted-by":"publisher","first-page":"e0222658","DOI":"10.1371\/journal.pone.0222658","article-title":"Cost-effectiveness of apixaban compared to other anticoagulants in patients with atrial fibrillation in the real-world and trial settings","volume":"14","author":"de Jong","year":"2019","journal-title":"Plos One"},{"key":"B24","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1007\/s10198-019-01123-5","article-title":"The contribution of real-world evidence to cost-effectiveness analysis: case study of Dabigatran etexilate in France","volume":"21","author":"de Pouvourville","year":"2020","journal-title":"Eur. J. Health Econ."},{"key":"B25","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1016\/j.hlc.2019.02.187","article-title":"Cost-effectiveness analysis of non-vitamin K antagonist oral anticoagulants versus warfarin in Thai patients with non-valvular atrial fibrillation","volume":"29","author":"Dilokthornsakul","year":"2020","journal-title":"Heart Lung Circ."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1897","DOI":"10.1093\/eurheartj\/ehu006","article-title":"Cost-effectiveness of apixaban vs. current standard of care for stroke prevention in patients with atrial fibrillation","volume":"35","author":"Dorian","year":"2014","journal-title":"Eur. Heart J."},{"key":"B27","doi-asserted-by":"publisher","first-page":"74","DOI":"10.14499\/indonesianjpharm30iss1pp74","article-title":"Cost effectiveness analysis of rivaroxaban compared to warfarin and aspirin for stroke prevention atrial fibrillation (SPAF) in the Indonesian healthcare setting","volume":"30","author":"Dwiprahasto","year":"2019","journal-title":"Indones. J. Pharm."},{"key":"B28","doi-asserted-by":"publisher","first-page":"e0266658","DOI":"10.1371\/journal.pone.0266658","article-title":"Real-world cost-effectiveness analysis of NOACs versus VKA for stroke prevention in Spain","volume":"17","author":"Escobar Cervantes","year":"2022","journal-title":"Plos One"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.7326\/0003-4819-154-1-201101040-00289","article-title":"Cost-effectiveness of dabigatran compared with warfarin for stroke prevention in atrial fibrillation","volume":"154","author":"Freeman","year":"2011","journal-title":"Ann. Intern Med."},{"key":"B30","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s13561-015-0052-8","article-title":"Estimation of the cost-effectiveness of apixaban versus vitamin K antagonists in the management of atrial fibrillation in Argentina","volume":"5","author":"Giorgi","year":"2015","journal-title":"Health Econ. Rev."},{"key":"B31","doi-asserted-by":"publisher","first-page":"2093","DOI":"10.1056\/NEJMoa1310907","article-title":"Edoxaban versus warfarin in patients with atrial fibrillation","volume":"369","author":"Giugliano","year":"2013","journal-title":"New Engl. J. Med."},{"key":"B32","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1056\/NEJMoa1107039","article-title":"Apixaban versus warfarin in patients with atrial fibrillation","volume":"365","author":"Granger","year":"2011","journal-title":"New Engl. J. Med."},{"key":"B33","doi-asserted-by":"publisher","first-page":"745","DOI":"10.2147\/CEOR.S317078","article-title":"Cost-effectiveness of apixaban versus other direct oral anticoagulants and warfarin in the prevention of thromboembolic complications among Finnish patients with non-valvular atrial fibrillation","volume":"13","author":"Hallinen","year":"2021","journal-title":"Clin. Outcomes Res."},{"key":"B34","doi-asserted-by":"publisher","first-page":"1354","DOI":"10.1186\/s40064-016-3024-5","article-title":"Cost-effectiveness of apixaban and warfarin in the prevention of thromboembolic complications among atrial fibrillation patients","volume":"5","author":"Hallinen","year":"2016","journal-title":"Springerplus"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1676","DOI":"10.1161\/STROKEAHA.111.000402","article-title":"Cost-effectiveness of apixaban, dabigatran, rivaroxaban, and warfarin for stroke prevention in atrial fibrillation","volume":"44","author":"Harrington","year":"2013","journal-title":"Stroke"},{"key":"B36","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1016\/j.thromres.2016.10.006","article-title":"Cost-effectiveness of non-vitamin K antagonist oral anticoagulants for stroke prevention in patients with atrial fibrillation at high risk of bleeding and normal kidney function","volume":"150","author":"Hernandez","year":"2017","journal-title":"Thromb. Res."},{"key":"B37","doi-asserted-by":"publisher","first-page":"265","DOI":"10.5144\/0256-4947.2019.265","article-title":"Cost-effectiveness of apixaban for stroke prevention in non-valvular atrial fibrillation in Saudi Arabia","volume":"39","author":"Hersi","year":"2019","journal-title":"Ann. Saudi Med."},{"key":"B38","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): the Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC","volume":"42","author":"Hindricks","year":"2021","journal-title":"Eur. Heart J."},{"key":"B39","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1080\/13696998.2019.1688821","article-title":"Cost-effectiveness of rivaroxaban versus warfarin for stroke prevention in non-valvular atrial fibrillation in the Japanese healthcare setting","volume":"23","author":"Hori","year":"2020","journal-title":"J. Med. Econ."},{"key":"B40","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1007\/s40256-018-0279-y","article-title":"Comparing the cost effectiveness of non-vitamin K antagonist oral anticoagulants with well-managed warfarin for stroke prevention in atrial fibrillation patients at high risk of bleeding","volume":"18","author":"Hospodar","year":"2018","journal-title":"Am. J. Cardiovasc Drug"},{"key":"B41","doi-asserted-by":"publisher","first-page":"57","DOI":"10.15887\/j.cnki.13-1389\/r.2019.16.029","article-title":"Cost-effectiveness analysis of rivaroxaban versus warfarin for stroke prevention in patients with nonvalvular atrial fibrillation","volume":"12","author":"Huang","year":"2019","journal-title":"Chin J Clin. Ration. Drug Use"},{"key":"B42","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.jval.2021.11.1351","article-title":"Consolidated health economic evaluation reporting standards 2022 (CHEERS 2022) statement: updated reporting guidance for health economic evaluations","volume":"25","author":"Husereau","year":"2022","journal-title":"Value Health"},{"key":"B43","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1007\/s40273-014-0246-7","article-title":"Cost effectiveness of novel oral anticoagulants for stroke prevention in atrial fibrillation depending on the quality of warfarin anticoagulation control","volume":"33","author":"Janzic","year":"2015","journal-title":"Pharmacoeconomics"},{"key":"B44","doi-asserted-by":"publisher","first-page":"1389","DOI":"10.1016\/j.clinthera.2014.08.016","article-title":"Cost-utility analysis of oral anticoagulants for nonvalvular atrial fibrillation patients at the police general hospital, Bangkok, Thailand","volume":"36","author":"Jarungsuccess","year":"2014","journal-title":"Clin. Ther."},{"key":"B45","doi-asserted-by":"publisher","first-page":"2837","DOI":"10.1016\/j.clinthera.2015.10.007","article-title":"Cost-effectiveness analysis of apixaban against warfarin for stroke prevention in patients with nonvalvular atrial fibrillation in Japan","volume":"37","author":"Kamae","year":"2015","journal-title":"Clin. Ther."},{"key":"B46","doi-asserted-by":"publisher","first-page":"1428","DOI":"10.1212\/WNL.0b013e31826d5fe8","article-title":"Cost-effectiveness of apixaban vs warfarin for secondary stroke prevention in atrial fibrillation","volume":"79","author":"Kamel","year":"","journal-title":"Neurology"},{"key":"B47","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1161\/STROKEAHA.111.641027","article-title":"Cost-effectiveness of dabigatran compared with warfarin for stroke prevention in patients with atrial fibrillation and prior stroke or transient ischemic attack","volume":"43","author":"Kamel","year":"","journal-title":"Stroke"},{"key":"B48","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1160\/TH12-06-0388","article-title":"Dabigatran versus rivaroxaban for the prevention of stroke and systemic embolism in atrial fibrillation in Canada. Comparative efficacy and cost-effectiveness","volume":"108","author":"Kansal","year":"2017","journal-title":"Thromb. Haemost."},{"key":"B49","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1136\/heartjnl-2011-300646","article-title":"Cost-effectiveness of dabigatran etexilate for the prevention of stroke and systemic embolism in UK patients with atrial fibrillation","volume":"98","author":"Kansal","year":"2012","journal-title":"Heart"},{"key":"B50","doi-asserted-by":"publisher","first-page":"252","DOI":"10.4070\/kcj.2018.0220","article-title":"Cost-effectiveness of rivaroxaban compared to warfarin for stroke prevention in atrial fibrillation","volume":"49","author":"Kim","year":"2019","journal-title":"Korean Circ. J."},{"key":"B51","doi-asserted-by":"publisher","first-page":"909","DOI":"10.1007\/s40273-013-0087-9","article-title":"Cost-effectiveness of rivaroxaban versus warfarin for stroke prevention in atrial fibrillation in the Belgian healthcare setting","volume":"31","author":"Kleintjens","year":"2013","journal-title":"Pharmacoeconomics"},{"key":"B52","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1007\/s40261-014-0253-7","article-title":"Stroke and systemic embolism prevention in patients with atrial fibrillation in Belgium: comparative cost effectiveness of new oral anticoagulants and warfarin","volume":"35","author":"Kongnakorn","year":"2015","journal-title":"Clin. Drug Invest"},{"key":"B53","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1186\/1478-7547-12-5","article-title":"Economic evaluation of rivaroxaban in stroke prevention for patients with atrial fibrillation in Greece","volume":"12","author":"Kourlaba","year":"2014","journal-title":"Cost. Eff. Resour. Alloc."},{"key":"B54","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1007\/s11239-013-0989-6","article-title":"Comparison of cost-effectiveness of anticoagulation with dabigatran, rivaroxaban and apixaban in patients with non-valvular atrial fibrillation across countries","volume":"37","author":"Krejczy","year":"2014","journal-title":"J. Thromb. Thrombolys"},{"key":"B55","doi-asserted-by":"publisher","first-page":"876923","DOI":"10.1155\/2015\/876923","article-title":"Cost-effectiveness of anticoagulation in patients with nonvalvular atrial fibrillation with edoxaban compared to warfarin in Germany","volume":"2015","author":"Krejczy","year":"2015","journal-title":"Biomed. Res. Int."},{"key":"B56","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.jclinepi.2016.05.018","article-title":"Latin American clinical epidemiology network series - paper 2: apixaban was cost-effective vs. acenocoumarol in patients with nonvalvular atrial fibrillation with moderate to severe risk of embolism in Chile","volume":"86","author":"Lanas","year":"2017","journal-title":"J. Clin. Epidemiol."},{"key":"B57","doi-asserted-by":"publisher","first-page":"695","DOI":"10.3111\/13696998.2012.673525","article-title":"Cost-effectiveness of dabigatran etexilate for stroke prevention in non-valvular atrial fibrillation. Applying RE-LY to clinical practice in Denmark","volume":"15","author":"Langkilde","year":"2012","journal-title":"J. Med. Econ."},{"key":"B58","doi-asserted-by":"publisher","first-page":"587","DOI":"10.3111\/13696998.2014.923891","article-title":"Stroke prevention in patients with atrial fibrillation in France: comparative cost-effectiveness of new oral anticoagulants (apixaban, dabigatran, and rivaroxaban), warfarin, and aspirin","volume":"17","author":"Lanitis","year":"2014","journal-title":"J. Med. Econ."},{"key":"B59","doi-asserted-by":"publisher","first-page":"E600","DOI":"10.1016\/S0735-1097(12)60601-9","article-title":"Cost-effectiveness of rivaroxaban compared to warfarin for stroke prophylaxis in atrial fibrillation","volume":"59","author":"Lee","year":"","journal-title":"J. Am. Coll. Cardiol."},{"key":"B60","doi-asserted-by":"publisher","first-page":"e47473","DOI":"10.1371\/journal.pone.0047473","article-title":"Cost-effectiveness of apixaban compared with warfarin for stroke prevention in atrial fibrillation","volume":"7","author":"Lee","year":"","journal-title":"Plos One"},{"key":"B61","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1016\/j.rec.2018.03.024","article-title":"Would the use of Edoxaban be cost-effective for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation in Spain?","volume":"72","author":"Lekuona","year":"2019","journal-title":"Rev. Espa\u00f1ola Cardiol. English Ed."},{"key":"B62","doi-asserted-by":"publisher","first-page":"e0157129","DOI":"10.1371\/journal.pone.0157129","article-title":"Cost-effectiveness of apixaban versus warfarin in Chinese patients with non-valvular atrial fibrillation: a real-life and modelling analyses","volume":"11","author":"Li","year":"2016","journal-title":"Plos One"},{"key":"B63","doi-asserted-by":"publisher","first-page":"50","DOI":"10.6515\/ACS.202001_36(1).20190511A","article-title":"Cost-effectiveness analysis of oral anticoagulants in stroke prevention among patients with atrial fibrillation in Taiwan","volume":"36","author":"Liao","year":"2020","journal-title":"Acta Cardiol. Sin."},{"key":"B64","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1177\/1747493019897870","article-title":"Global epidemiology of atrial fibrillation: an increasing epidemic and public health challenge","volume":"16","author":"Lippi","year":"2021","journal-title":"Int. J. Stroke"},{"key":"B65","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1007\/s40261-016-0487-7","article-title":"Cost-effectiveness analysis of apixaban, dabigatran, rivaroxaban, and warfarin for stroke prevention in atrial fibrillation in Taiwan","volume":"37","author":"Liu","year":"2017","journal-title":"Clin. Drug Invest"},{"key":"B66","doi-asserted-by":"publisher","first-page":"658","DOI":"10.1111\/jcpt.13318","article-title":"Cost-effectiveness of rivaroxaban versus warfarin in non-valvular atrial fibrillation patients with chronic kidney disease in China","volume":"46","author":"Liu","year":"2021","journal-title":"J. Clin. Pharm. Ther."},{"key":"B67","doi-asserted-by":"publisher","first-page":"j5058","DOI":"10.1136\/bmj.j5058","article-title":"Oral anticoagulants for prevention of stroke in atrial fibrillation: systematic review, network meta-analysis, and cost effectiveness analysis","volume":"359","author":"L\u00f3pez-L\u00f3pez","year":"2017","journal-title":"BMJ"},{"key":"B68","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1007\/s40261-021-01002-z","article-title":"Cost-effectiveness of direct non-vitamin K oral anticoagulants versus vitamin K antagonists for the management of patients with non-valvular atrial fibrillation based on available real-world evidence: the Italian national health system perspective","volume":"41","author":"Lorenzoni","year":"2021","journal-title":"Clin. Drug Investig."},{"key":"B69","doi-asserted-by":"publisher","first-page":"15","DOI":"10.12010\/j.issn.1673-5846.2019.03.003","article-title":"Cost-utility analysis of left atrial appendage closure and new oral anticoagulants for stroke prevention in patients with atrial fibrillation","volume":"14","author":"Lv","year":"2019","journal-title":"China J. Pharm. Econ."},{"key":"B70","doi-asserted-by":"publisher","first-page":"1140","DOI":"10.1016\/j.ahj.2015.09.011","article-title":"Cost-effectiveness of edoxaban vs warfarin in patients with atrial fibrillation based on results of the ENGAGE AF-TIMI 48 trial","volume":"170","author":"Magnuson","year":"2015","journal-title":"Am. Heart J."},{"key":"B71","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.rccar.2018.10.011","article-title":"Cost-effectiveness of new oral anticoagulants and warfarin in atrial fibrillation from adverse events perspective","volume":"26","author":"Mendoza","year":"2019","journal-title":"Rev. Colomb. Cardiol."},{"key":"B72","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1007\/s40273-014-0236-9","article-title":"Cost effectiveness of rivaroxaban for stroke prevention in German patients with atrial fibrillation","volume":"33","author":"Mensch","year":"2015","journal-title":"Pharmacoeconomics"},{"key":"B73","doi-asserted-by":"publisher","first-page":"e1000097","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"Moher","year":"2009","journal-title":"Plos Med."},{"key":"B74","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1016\/j.repc.2014.02.020","article-title":"Cost-effectiveness of rivaroxaban for stroke prevention in atrial fibrillation in the Portuguese setting","volume":"33","author":"Morais","year":"2014","journal-title":"Rev. Port. Cardiol."},{"key":"B75","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.thromres.2019.11.012","article-title":"Cost-effectiveness of warfarin care bundles and novel oral anticoagulants for stroke prevention in patients with atrial fibrillation in Thailand","volume":"185","author":"Ng","year":"2020","journal-title":"Thromb. Res."},{"key":"B76","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1002\/phar.1746","article-title":"Cost-effectiveness of high-dose edoxaban compared with adjusted-dose warfarin for stroke prevention in non-valvular atrial fibrillation patients","volume":"36","author":"Nguyen","year":"2016","journal-title":"Pharmacotherapy"},{"key":"B77","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1136\/bmjebm-2020-111634","article-title":"Economic evaluation of direct oral anticoagulants (DOACs) versus vitamin K antagonists (VKAs) for stroke prevention in patients with atrial fibrillation: a systematic review and meta-analysis","volume":"27","author":"Noviyani","year":"2022","journal-title":"BMJ Evidence-Based Med."},{"key":"B78","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/1477-9560-11-14","article-title":"Dabigatran versus warfarin under standard or pharmacogenetic-guided management for the prevention of stroke and systemic thromboembolism in patients with atrial fibrillation: a cost\/utility analysis using an analytic decision model","volume":"11","author":"Nshimyumukiza","year":"2013","journal-title":"Thromb. J."},{"key":"B79","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1056\/NEJMoa1009638","article-title":"Rivaroxaban versus warfarin in nonvalvular atrial fibrillation","volume":"365","author":"Patel","year":"2011","journal-title":"New Engl. J. Med."},{"key":"B80","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1016\/j.vhri.2015.02.003","article-title":"Cost-effectiveness and cost-utility analyses of dabigatran compared with warfarin in patients with nonvalvular atrial fibrillation and risk factors for stroke and systemic embolism within Brazilian private and public health care systems perspectives","volume":"8","author":"Pepe","year":"2015","journal-title":"Value Health Reg. Issues"},{"key":"B81","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1038\/clpt.2013.190","article-title":"Cost-effectiveness of pharmacogenetics-guided warfarin therapy vs. alternative anticoagulation in atrial fibrillation","volume":"95","author":"Pink","year":"2014","journal-title":"Clin. Pharmacol. Ther."},{"key":"B82","doi-asserted-by":"publisher","first-page":"w13732","DOI":"10.4414\/smw.2013.13732","article-title":"Cost-effectiveness of dabigatran for stroke prevention in atrial fibrillation in Switzerland","volume":"143","author":"Pletscher","year":"2013","journal-title":"Swiss Med. Wkly."},{"key":"B83","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1007\/s40273-018-0741-3","article-title":"Cost-effectiveness analysis of direct-acting oral anticoagulants for stroke prevention in Thai patients with non-valvular atrial fibrillation and a high risk of bleeding","volume":"37","author":"Rattanachotphanit","year":"2019","journal-title":"Pharmacoeconomics"},{"key":"B84","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1007\/s41669-022-00337-3","article-title":"Cost effectiveness of patient self-managed warfarin compared with direct oral anticoagulants in atrial fibrillation: an economic evaluation in a Danish healthcare sector setting","volume":"6","author":"Raunbak","year":"2022","journal-title":"PharmacoEconomics - Open"},{"key":"B85","doi-asserted-by":"publisher","first-page":"e0259251","DOI":"10.1371\/journal.pone.0259251","article-title":"Cost-effectiveness analysis of apixaban versus vitamin K antagonists for antithrombotic therapy in patients with atrial fibrillation after acute coronary syndrome or percutaneous coronary intervention in Spain","volume":"16","author":"Rivolo","year":"2021","journal-title":"Plos One"},{"key":"B86","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1007\/s40261-013-0144-3","article-title":"Apixaban, dabigatran, and rivaroxaban versus warfarin for stroke prevention in non-valvular atrial fibrillation: a cost-effectiveness analysis","volume":"34","author":"Rognoni","year":"2014","journal-title":"Clin. Drug Invest."},{"key":"B87","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1007\/s11239-014-1104-3","article-title":"Edoxaban versus warfarin for stroke prevention in non-valvular atrial fibrillation: a cost-effectiveness analysis","volume":"39","author":"Rognoni","year":"2015","journal-title":"J. Thromb. Thrombolysis"},{"key":"B88","doi-asserted-by":"publisher","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","article-title":"Global burden of cardiovascular diseases and risk factors, 1990-2019: update from the GBD 2019 study","volume":"76","author":"Roth","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"B89","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.amjcard.2015.09.048","article-title":"Cost-effectiveness of dabigatran (150 mg twice daily) and warfarin in patients \u2265 65 Years with nonvalvular atrial fibrillation","volume":"117","author":"Salata","year":"2016","journal-title":"Am. J. Cardiol."},{"key":"B90","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/j.ijcard.2018.11.087","article-title":"Cost-effectiveness of rivaroxaban versus warfarin for treatment of nonvalvular atrial fibrillation in patients with worsening renal function","volume":"282","author":"Salcedo","year":"2019","journal-title":"Int. J. Cardiol."},{"key":"B91","doi-asserted-by":"publisher","first-page":"1555","DOI":"10.1161\/STROKEAHA.115.012325","article-title":"Cost-effectiveness of oral anticoagulants for ischemic stroke prophylaxis among nonvalvular atrial fibrillation patients","volume":"47","author":"Shah","year":"2016","journal-title":"Stroke"},{"key":"B92","doi-asserted-by":"publisher","first-page":"2562","DOI":"10.1161\/CIRCULATIONAHA.110.985655","article-title":"Cost-effectiveness of dabigatran for stroke prophylaxis in atrial fibrillation","volume":"123","author":"Shah","year":"2011","journal-title":"Circulation"},{"key":"B93","doi-asserted-by":"publisher","first-page":"908","DOI":"10.1160\/TH11-02-0089","article-title":"Cost-effectiveness of dabigatran etexilate for the prevention of stroke and systemic embolism in atrial fibrillation: a Canadian payer perspective","volume":"105","author":"Sorensen","year":"2011","journal-title":"Thromb. Haemost."},{"key":"B94","doi-asserted-by":"publisher","first-page":"1612","DOI":"10.1093\/europace\/euab065","article-title":"2021 European heart rhythm association practical guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation","volume":"23","author":"Steffel","year":"2021","journal-title":"EP Eur."},{"key":"B95","doi-asserted-by":"publisher","first-page":"e103974","DOI":"10.1371\/journal.pone.0103974","article-title":"Economic evaluation of apixaban for the prevention of stroke in non-valvular atrial fibrillation in The Netherlands","volume":"9","author":"Stevanovic","year":"2014","journal-title":"Plos One"},{"key":"B96","doi-asserted-by":"publisher","first-page":"2381468319866828","DOI":"10.1177\/2381468319866828","article-title":"Directly acting oral anticoagulants for the prevention of stroke in atrial fibrillation in England and Wales: cost-effectiveness model and value of information analysis","volume":"4","author":"Thom","year":"2019","journal-title":"MDM Policy Pract."},{"key":"B97","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1080\/13696998.2017.1372222","article-title":"The cost-effectiveness and monetary benefits of dabigatran in the prevention of arterial thromboembolism for patients with non-valvular atrial fibrillation in The Netherlands","volume":"21","author":"van Hulst","year":"2018","journal-title":"J. Med. Econ."},{"key":"B98","doi-asserted-by":"publisher","first-page":"2844","DOI":"10.1161\/STROKEAHA.118.022596","article-title":"Anticoagulation therapy for atrial fibrillation in patients with Alzheimer's disease","volume":"49","author":"Vargas","year":"2018","journal-title":"Stroke"},{"key":"B99","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1007\/s40256-014-0092-1","article-title":"Cost effectiveness of new oral anticoagulants for stroke prevention in patients with atrial fibrillation in two different European healthcare settings","volume":"14","author":"Verhoef","year":"2014","journal-title":"Am. J. Cardiovasc Drug"},{"key":"B100","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1016\/j.vhri.2017.03.011","article-title":"Cost-effectiveness of Edoxaban vs. warfarin in patients with atrial fibrillation based on results of the ENGAGE AF - TIMI 48 trial: Taiwanese perspective","volume":"12","author":"Vilain","year":"2017","journal-title":"Value Health Reg. Issues"},{"key":"B101","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1080\/14737167.2020.1798233","article-title":"Cost-effectiveness analysis of apixaban compared to other direct oral anticoagulants for prevention of stroke in Austrian atrial fibrillation patients","volume":"21","author":"Walter","year":"2021","journal-title":"Expert Rev. Pharm. Out."},{"key":"B102","first-page":"608","article-title":"Cost-effectiveness of dabigatran compared with warfarin for stroke prevention in atrial fibrillation in China","volume":"31","author":"Wan","year":"2014","journal-title":"Chin. J. Health Statistics"},{"key":"B103","doi-asserted-by":"publisher","first-page":"1333","DOI":"10.1007\/s40273-020-00960-0","article-title":"Updating the cost effectiveness of oral anticoagulants for patients with atrial fibrillation based on varying stroke and bleed risk profiles","volume":"38","author":"Wang","year":"2020","journal-title":"Pharmacoeconomics"},{"key":"B104","doi-asserted-by":"publisher","first-page":"39","DOI":"10.12010\/j.issn.1673-5846.2022.08.006","article-title":"Pharmacoeconomic valuation of strategies for treatment of nonvalvular atrial fibrillation based on Markov model","volume":"17","author":"Wang","year":"2022","journal-title":"China J. Pharm. Econ."},{"key":"B105","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1007\/s10557-014-6558-1","article-title":"Cost-effectiveness of dabigatran and rivaroxaban compared with warfarin for stroke prevention in patients with atrial fibrillation","volume":"28","author":"Wang","year":"2014","journal-title":"Cardiovasc Drugs Ther."},{"key":"B106","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1186\/s12913-021-06084-1","article-title":"Cost-effectiveness analysis of dabigatran, rivaroxaban and warfarin in the prevention of stroke in patients with atrial fibrillation in China","volume":"21","author":"Wei","year":"2021","journal-title":"Bmc Health Serv. Res."},{"key":"B107","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1007\/s40273-014-0152-z","article-title":"Economic evaluation of warfarin, dabigatran, rivaroxaban, and apixaban for stroke prevention in atrial fibrillation","volume":"32","author":"Wisl\u00f8ff","year":"2014","journal-title":"Pharmacoeconomics"},{"key":"B108","doi-asserted-by":"publisher","first-page":"407","DOI":"10.3111\/13696998.2013.766200","article-title":"Cost-effectiveness of dabigatran etexilate in the prevention of stroke and systemic embolism in patients with atrial fibrillation in Belgium","volume":"16","author":"Wouters","year":"2013","journal-title":"J. Med. Econ."},{"key":"B109","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1007\/s10557-013-6490-9","article-title":"Cost-effectiveness of different strategies for stroke prevention in patients with atrial fibrillation in a health resource-limited setting","volume":"28","author":"Wu","year":"2014","journal-title":"Cardiovasc Drugs Ther."},{"key":"B110","doi-asserted-by":"publisher","first-page":"1003","DOI":"10.13286\/j.cnki.chinhosppharmacyj.2016.12.11","article-title":"Cost-effectiveness of novel oral anticoagulants versus Warfarin for stroke prevention in patients with non-valvular atrial fibrillation","volume":"36","author":"Wu","year":"","journal-title":"Chin. Hosp. Pharm. J."},{"key":"B111","doi-asserted-by":"publisher","first-page":"1183","DOI":"10.13748\/j.cnki.issn1007-7693.2016.09.021","article-title":"Cost-effectiveness of apixaban vs warfarin for secondary stroke prevention of atrial fibrillation","volume":"33","author":"Wu","year":"","journal-title":"Chin. J. Mod. Appl. Pharm."},{"key":"B112","doi-asserted-by":"publisher","first-page":"675200","DOI":"10.3389\/fcvm.2021.675200","article-title":"Cost-effectiveness analysis of direct oral anticoagulants vs. vitamin K antagonists in the elderly with atrial fibrillation: insights from the evidence in a real-world setting","volume":"8","author":"Wu","year":"2021","journal-title":"Front. Cardiovasc Med."},{"key":"B113","doi-asserted-by":"publisher","first-page":"e069573","DOI":"10.1136\/bmj-2021-069573","article-title":"Industry sponsorship bias in cost effectiveness analysis: registry based analysis","volume":"377","author":"Xie","year":"2022","journal-title":"BMJ"},{"key":"B114","volume-title":"The clinical evaluation of warfarin and its pharmacoeconomic evaluation with rivaroxaban","author":"Yang","year":"2021"},{"key":"B115","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1007\/s11606-013-2639-2","article-title":"Novel oral anticoagulants versus warfarin therapy at various levels of anticoagulation control in atrial fibrillation\u2014a cost-effectiveness analysis","volume":"29","author":"You","year":"2014","journal-title":"J. Gen. Intern Med."},{"key":"B116","doi-asserted-by":"publisher","first-page":"794","DOI":"10.1016\/j.ijcard.2016.06.087","article-title":"Cost-effectiveness modelling of novel oral anticoagulants incorporating real-world elderly patients with atrial fibrillation","volume":"220","author":"Zhao","year":"2016","journal-title":"Int. J. Cardiol."},{"key":"B117","doi-asserted-by":"publisher","first-page":"2015","DOI":"10.1016\/j.clinthera.2014.09.015","article-title":"Comparison of the cost-effectiveness of new oral anticoagulants for the prevention of stroke and systemic embolism in atrial fibrillation in a UK setting","volume":"36","author":"Zheng","year":"2014","journal-title":"Clin. Ther."},{"key":"B118","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1111\/jcpt.13575","article-title":"Cost-effectiveness of anticoagulants for preventing stroke in patients with non-valvular atrial fibrillation in mainland China","volume":"47","author":"Zhou","year":"2022","journal-title":"J. Clin. Pharm. Ther."}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2025.1441754\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T09:01:18Z","timestamp":1743152478000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2025.1441754\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,28]]},"references-count":118,"alternative-id":["10.3389\/fphar.2025.1441754"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2025.1441754","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,28]]},"article-number":"1441754"}}