Journal of Cardiac Failure
Volume 15, Issue 10 , Pages 819-827, December 2009

Resource Use and Costs of Treatment With Anticoagulation and Antiplatelet Agents: Results of the WATCH Trial Economic Evaluation

  • Mark E. Patterson, PhD, MPH

      Affiliations

    • Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
    • ,
  • William C. Grant, PhD

      Affiliations

    • Department of Economics, James Madison University, Harrisonburg, Virginia
    • ,
  • Seth W. Glickman, MD, MBA

      Affiliations

    • Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
    • ,
  • Barry M. Massie, MD

      Affiliations

    • San Francisco Veterans Affairs Medical Center and University of California, San Francisco
    • ,
  • Susan E. Ammon, MS, RN, FNP

      Affiliations

    • San Francisco Veterans Affairs Medical Center and University of California, San Francisco
    • ,
  • Paul W. Armstrong, MD

      Affiliations

    • University of Alberta, Edmonton
    • ,
  • John G.F. Cleland, MD

      Affiliations

    • Department of Cardiology, Castle Hill Hospital, University of Hull, Kingston-Upon-Hull, United Kingdom
    • ,
  • Joseph F. Collins, SCD

      Affiliations

    • Cooperative Studies Program Coordinating Center, VA Maryland Health Care System, Perry Point, Maryland
    • ,
  • Koon K. Teo, MBBCH, PhD

      Affiliations

    • McMaster University Medical Center, Hamilton, Ontario
    • ,
  • Kevin A. Schulman, MD

      Affiliations

    • Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
    • ,
  • Shelby D. Reed, PhD

      Affiliations

    • Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
    • Corresponding Author InformationReprint requests: Shelby D. Reed, PhD, Center for Clinical Genetics and Economics, Duke Clinical Research Institute, PO Box 17969, Durham, NC 27715. Tel: (919) 668-8101; Fax: (919) 668-7124

Received 7 July 2008; received in revised form 1 May 2009; accepted 1 July 2009. published online 24 August 2009.

Abstract 

Background

The Warfarin and Antiplatelet Therapy in Chronic Heart Failure (WATCH) trial revealed no significant differences among 1587 symptomatic heart failure patients randomized to warfarin, clopidogrel, or aspirin in time to all-cause death, nonfatal myocardial infarction, or nonfatal stroke. We compared within-trial medical resource use and costs between treatments.

Methods and Results

We assigned country-specific costs to medical resources incurred during follow-up. Annualized rates of hospitalizations, inpatient and outpatient procedures, and emergency department visits did not differ significantly between groups. Annualized total costs averaged $5901 (95% confidence interval [CI], $4776-$7520) for the aspirin group, $5646 (95% CI, $4903-$6584) for the clopidogrel group, and $5830 (95% CI, $4838-$7400) for the warfarin group.

Conclusions

Consistent with clinical findings, our analyses did not identify significant cost differences between treatments.

Key Words: Anticoagulants, aspirin, health care costs, heart failure, internationality, platelet aggregation inhibitors, warfarin

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 All decisions regarding this manuscript were made by a guest editor.

 The WATCH trial was conducted under the auspices of the US Department of Veterans Affairs Cooperative Study Program, with partial unrestricted support from Bristol-Myers Squibb Company and Sanofi-Aventis.

PII: S1071-9164(09)00681-2

doi:10.1016/j.cardfail.2009.07.004

Journal of Cardiac Failure
Volume 15, Issue 10 , Pages 819-827, December 2009

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