In patients with stable coronary artery disease (CAD) or peripheral vascular disease (PAD), the use of rivaroxaban in combination with aspirin has the potential to save $682 per patient in direct costs of hospitalization, procedures and cardiovascular events, according to an in-trial cost analysis of the COMPASS trial presented Nov. 14 at AHA 2017 in Anaheim, CA.

Andre Lamy, MD, MHS, et al., looked at 9,152 patients who received 2.5 mg of rivaroxaban twice-daily in combination with 100 mg of aspirin daily vs. 9,126 patents who received 100 mg of aspirin daily. For this cost analysis, they used the direct costs during hospitalization and the one-year perspective for events.

Results showed that the mean event and procedure cost per participant in the U.S. was $3,964 in the rivaroxaban plus aspirin group, vs. $4,646 in the aspirin group. This difference in cost of $682 per participant for events and procedures results in a total cost difference of $6,144,221 between the two groups over the mean follow-up of 23 months. In this analysis, there findings were similar for Canada, France and Germany.

The researchers explain that there were limitations to the study since rivaroxaban 2.5mg twice-daily plus aspirin is not yet approved for this indication and the list price is unknown.

They conclude that 2.5 mg of rivaroxaban twice-daily in combination with 100 mg of aspirin daily is "clinically better" than 100 mg of aspirin daily, and that it decreases direct medical costs of hospitalization, procedures and major cardiovascular events.

Keywords: AHA17, AHA Annual Scientific Sessions, Aspirin, Costs and Cost Analysis, Platelet Aggregation Inhibitors, Factor Xa Inhibitors

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