Patient's place of residence matters when choosing cost-effective anticoagulation therapy

November 27, 2019

Appropriately selected anticoagulation therapy can help to reduce the medical costs of patients suffering from atrial fibrillation. A new study from the University of Eastern Finland shows that direct oral anticoagulants can be a more cost-effective alternative than traditional warfarin therapy when the patient's place of residence is taken into consideration. Published in Geospatial Health, the study used GIS data to create a geospatial model comparing the costs of different anticoagulant therapies. The patient's travel, time-loss and medication costs were used parameters to determine the overall costs of therapy.

Most atrial fibrillation patients need anticoagulation management to reduce the risk of thromboembolic events and stroke. Currently, two major drug therapies are available: warfarin and direct oral anticoagulants (DOACs).

Patients receiving warfarin therapy require regular INR monitoring. As a result, warfarin therapy is more cost-effective than DOACs only when the patient lives near the INR sample collection point, due to higher costs of travel and greater loss of leisure or working time. The study found that DOACs are a more cost-effective alternative also in situations where the patient requires INR monitoring more frequently than normal.

The researchers developed a geospatial model that determines market areas DOAC and warfarin therapy, taking into consideration the costs of travel, time-loss caused by INR monitoring, different modes of travel and the patient's assumed working or retirement status. Using this data, they calculated distance limits for each market area by mode of transport, making is possible to compare the spatial costs of warfarin therapy also when using different modes of travel. The study compared the costs of warfarin and DOAC therapy in a hospital district in the eastern part of Finland.

The data used in the study included the regional sample collection point locations, the Finnish National Road and Street Database, and recent travel and medical cost parameters from the study area. The costs were looked at from the patient's perspective, taking into consideration possible national reimbursements of medical costs and costs of using a taxi.

"Our model pertains to Finland, but it is possible to create a similar geospatial model for other countries as well, provided that road data and the required parameters are available. It is also possible to use this model to compare other drugs that have a treatment setting that is similar to anticoagulant therapy," Project Researcher and lead author of the study Mikko Pyykönen from the University of Eastern Finland notes.
For further information, please contact: Project Researcher Mikko Pyykönen, tel. +358 50 505 1480,

Research article: Pyykönen M, Leminen A, Tynkkynen J, Tykkyläinen M, Laatikainen T. Geospatial model to determine the spatial cost-efficiency of anticoagulation drug therapy: Patients' perspective. Geospatial Health 2019, 14: 809. doi:

University of Eastern Finland

Related Atrial Fibrillation Articles from Brightsurf:

Atrial fibrillation less deadly than it used to be, but still cause for concern: BU study
A first-of-its-kind study by researchers from the Boston University School of Public Health (BUSPH) shows a decline in deaths related to atrial fibrillation (irregular heartbeat) over the last 45 years.

Postoperative atrial fibrillation does not impact on overall survival after esophagectomy
Volume 11, Issue 25 of Oncotarget reported that Administration of landiolol hydrochloride was found to be associated with reduced incidence of atrial fibrillation after esophagectomy for esophageal cancer in our previous randomized controlled trial.

People with atrial fibrillation live longer with exercise
More than 100,000 Norwegians have atrial fibrillation. They should be actively exercising for their health.

Atrial fibrillation among overweight people is not due to fat
In a recently published study, researchers from Aarhus University document that the risk of atrial fibrillation is not linked to the amount of body fat, but instead to large muscle mass, or more precisely, a high fat-free weight

Eating more protein could help ward off atrial fibrillation in women
Women who ate slightly more than the recommended daily amount of protein were significantly less likely to develop atrial fibrillation (AFib), a dangerous heart rhythm disorder that can lead to stroke and heart failure, when compared with those who consumed less protein, according to research being presented at the American College of Cardiology's Annual Scientific Session Together with World Congress of Cardiology (ACC.20/WCC).

Zebrafish teach researchers more about atrial fibrillation
Genetic research in zebrafish at the University of Copenhagen has surprised the researchers behind the study.

Personalized medicine for atrial fibrillation
The study, published in Europace, uses signals from implantable devices -- pacemakers and defibrillators -- to analyze electrical signals in the heart during episodes of atrial fibrillation.

Prescribing anticoagulants in the ED for atrial fibrillation increases long-term use by 30%
Patients prescribed anticoagulants after a diagnosis of atrial fibrillation in the emergency department are more likely to continue long-term use of medications to treat the condition, according to research published in CMAJ (Canadian Medical Association Journal).

Anticoagulant benefits for atrial fibrillation decrease with age
The net clinical benefit of anticoagulants for atrial fibrillation (AF) -- one of the most important causes of irregular heartbeats and a leading cause of stroke -- decreases with age, as the risk of death from other factors diminishes their benefit in older patients, according to a study led by researchers at UC San Francisco.

Research improves understanding of mechanism of atrial fibrillation
Mouse model studies show that noncoding DNA regions linked to atrial fibrillation risk can display long-range regulatory functions directed at Pitx2 gene and in this way predispose to the condition.

Read More: Atrial Fibrillation News and Atrial Fibrillation Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to