Costs of gastrointestinal bleeding events in atrial fibrillation: a UK Clinical Practice Research Datalink study

Future Cardiol. 2019 Sep;15(5):367-375. doi: 10.2217/fca-2019-0033. Epub 2019 Jul 26.

Abstract

Aim: To estimate the healthcare costs attributable to gastrointestinal (GI) bleeds in nonvalvular atrial fibrillation (NVAF) patients. Material & methods: A difference-in-differences approach was used in which NVAF patients suffering a (GI) bleed were propensity score matched to those not suffering a GI bleed, and the difference in healthcare costs in the year prior to the GI bleed and the subsequent 3 years was compared between the two groups. Results: The mean cost attributable to GI bleeds was £3989 (p < 0.0001) in the year of the bleed and £1816 (p = 0.001) in the subsequent year. Attributable costs arose primarily from inpatient visits. Conclusion: GI bleeds among NVAF patients are associated with significant healthcare costs up to 2 years following the bleed.

Keywords: CPRD; Clinical Practice Research Datalink; England; HES; Hospital Episode Statistics; NVAF; apixaban; dabigatran; edoxaban; gastrointestinal bleeding; nonvalvular atrial fibrillation; oral anticoagulant; rivaroxaban; vitamin K antagonist.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anticoagulants / adverse effects
  • Anticoagulants / therapeutic use*
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / drug therapy*
  • Cost of Illness*
  • Female
  • Follow-Up Studies
  • Gastrointestinal Hemorrhage / chemically induced
  • Gastrointestinal Hemorrhage / economics*
  • Gastrointestinal Hemorrhage / epidemiology
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Propensity Score*
  • Registries*
  • Retrospective Studies
  • Stroke / complications
  • Stroke / economics
  • Stroke / prevention & control*
  • United Kingdom / epidemiology

Substances

  • Anticoagulants