- Adding rivaroxaban (Xarelto) or icosapent ethyl (IE) to aspirin or statins, respectively, for patients with cardiovascular disease (CVD) offers a “small-to-substantial” health benefit in terms of reduced mortality.
- These additions also offer cost-effectiveness, according to analysis from the Institute for Clinical and Economic Review.
Why this matters
- Optimizing treatment while avoiding high costs is an ongoing struggle.
- For patients with stable CVD, adding rivaroxaban to aspirin is tied to reduced cardiovascular death, stroke, myocardial infarction, with a significant increase in the most severe bleeding events.
- These authors concluded with “high certainty” that this addition would provide a “small-to-substantial” net health benefit for patients with CVD, peripheral artery disease, or both.
- They could not confidently determine how the combination compared with dual antiplatelet therapy because data were insufficient.
- IE added some benefit vs optimal medical management alone for patients with established CVD or diabetes mellitus and further risk factors who are taking statins.
- These authors had “high certainty” of a “small-to-substantial” benefit with this addition.
- Both additions fell within cost-effectiveness thresholds.
- This group modeled these additions vs comparators in terms of patient survival, quality-adjusted survival, and health care costs.
- Funding: Laura and John Arnold Foundation; others.
- Other cardiovascular events not considered.