To the Editor: The Australian Government’s recently completed Review of anticoagulation therapies in atrial fibrillation (AF) identified that the quality of international normalised ratio (INR) control was one of a number of factors creating uncertainty regarding the cost-effectiveness of novel anticoagulants in the Australian setting.1
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- 1. Department of Health and Ageing. Review of anticoagulation therapies in atrial fibrillation. Final report. 2012. http://www.pbs.gov.au/info/publication/factsheets/shared/anticoagulation-review (accessed Feb 2013).
- 2. Wallentin L, Yusuf S, Ezekowitz MD, et al. Efficacy and safety of dabigatran compared with warfarin at different levels of international normalised ratio control for stroke prevention in atrial fibrillation: an analysis of the RE-LY trial. Lancet 2010; 376: 975-983.
- 3. Shah SV, Gage BF. Cost-effectiveness of dabigatran for stroke prophylaxis in atrial fibrillation. Circulation 2011; 123: 2562-2570.
- 4. White HD, Gruber M, Feyzi J, et al. Comparison of outcomes among patients randomized to warfarin therapy accprding to anticoagulant control: results from SPORTIF III and V. Arch Intern Med 2007; 167: 239-245.
- 5. Wan Y, Heneghan C, Perera R, et al. Anticoagulation control and prediction of adverse events in patients with atrial fibrillation: a systematic review. Circ Cardiovasc Qual Outcomes 2008; 1: 84-91.
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We thank Peter Gee for analysing project data and Daniel Owens for facilitating access to pathology data and assisting with the project.
Luke Bereznicki and Gregory Peterson have received consultancy fees from Aspen Pharmacare Australia and Boehringer Ingelheim. Luke Bereznicki has also received consultancy fees from Roche Diagnostics Australia and Sanofi Aventis, and speakers honoraria from Roche Diagnostics Australia and Boehringer Ingelheim.