Analysis of direct costs associated with the use of warfarin in patients with atrial fibrillation

Aim. To analyze the structure of expenses associated with warfarin dose adjustment and international normalized ratio (INR) control for patients with atrial fibrillation (AF) per 1 year of treatment. Material and methods. AF prevalence rate was calculated according to the large population studies data. The study was performed based on methodology for Cost of Illness evaluation. Expenses associated with INR monitoring within the obligatory medical insurance program were calculated based on the general tariff agreement for 2011 year for one of the territorial subject of Russia. Expenses associated with INR monitoring in outpatient departments of university clinics and commercial laboratories were calculated based on price list of respective institutes. Expenses associated with INR monitoring in case of self-monitoring were calculated based on expenses for portable coagulometer and test strips purchasing. Results. Around 539 000 people in Russia are needed warfarin therapy and associated continuous INR monitoring. In the obligatory medical insurance program the cost of warfarin is less than 1% of total costs and the direct costs of treatment and control of nearly 4 058.12 RUR/person per year, in university clinics, respectively, 0.03%, and 13 019.05 RUR, in case of selfmonitoring -0.01-0.05% and from 40 405.00 (in the first year) to7 404.98 RUR (in the consequent years), respectively. Conclusion. The cost of warfarin, regardless of the INR monitoring approach is less than 1% of the total cost of the treatment with therapy efficacy and safety control.