PATIENT-REPORTED OUTCOMES AND PHARMACOECONOMIC ANALYSIS OF PATIENTS TAKING ANTICOAGULANTS IN SINGAPORE

Abstract

This project had two objectives: 1) to assess patients? medication adherence, knowledge, satisfaction and concerns regarding warfarin therapy, and their associations with the control of International Normalized Ratios (INRs), and 2) to assess the cost-effectiveness of dabigatran and rivaroxaban compared with warfarin in patients with atrial fibrillation (AF), using local utilities in Singapore. This project had several major findings: 1) a patient-reported medication adherence scale was validated; 2) the medication refill adherence was found to be associated with most of the INR measures; 3) patients with better knowledge, higher warfarin adherence, higher satisfaction and fewer concerns were more likely to have better INR control; 4) ischemic stroke and intracranial hemorrhage had a significant impact on patients? health-related quality of life; 5) rivaroxaban was cost-effective compared with warfarin and had extended dominance over dabigatran 150 mg in patients with AF in Singapore. The results were confirmed in the probabilistic sensitivity analysis.