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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">As a health economist&#44; with a particular interest in the economic evaluation of drugs&#44; I was pleased to read the article &#8220;Cost-effectiveness of rivaroxaban for stroke prevention in atrial fibrillation in the Portuguese setting&#8221; by Morais et al&#46; in volume 33&#44; issue 9&#44; of the <span class="elsevierStyleItalic">Journal</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">It is increasingly clear that as well as the criteria of efficacy&#44; safety and quality that are required for market authorization&#44; the cost-effectiveness of a drug should also be taken into consideration&#46; This is essential to ensure the best use of resources and thus better health outcomes&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Of course&#44; this objective can only be fully achieved if the medical community has access to studies published in journals of recognized scientific quality and prestige&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">However&#44; despite improvements over the last 15 years&#44; a significant proportion of the medical community lacks the necessary tools to perform a critical analysis of a study&#39;s results or to identify factors that could affect them&#46; It is thus essential that at least the main parameters used in a particular study should be explained in a transparent fashion&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">As the lead author of the article &#8220;Economic evaluation of dabigatran for stroke prevention in patients with non-valvular atrial fibrillation&#8221;&#44; published in volume 32&#44; issue 7&#8211;8&#44; of the <span class="elsevierStyleItalic">Journal</span>&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a> I carried out a careful analysis of the results presented by Morais et al&#46; Comparison between the two studies showed that the differences stem from the different financial costs assigned to monitoring patients under warfarin&#46; As readers will naturally compare the two articles&#44; I consider it essential that the authors of the cost-effectiveness study of rivaroxaban clearly specify this parameter&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">I would also like to point out that there appears to be an error in Table 4 &#40;&#8220;Cost-effectiveness results of base-case analysis&#8221;&#41; of the article by Morais et al&#46; In this table&#44; the authors report the total costs for both drugs and separate costs for drug acquisition&#44; drug administration&#44; and event treatment&#46; However&#44; the sum of the latter does not equal the total&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this investigation&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appears in this article&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appears in this article&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare&#46;</p></span></span>"
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Journal Information
Vol. 34. Issue 11.
Pages 705-706 (November 2015)
Vol. 34. Issue 11.
Pages 705-706 (November 2015)
Letter to the Editor
Open Access
Comment on “Cost-effectiveness of rivaroxaban for stroke prevention in atrial fibrillation in the Portuguese setting”
Comentário a estudo de custo-efetividade de rivaroxabano para prevenção de acidente vascular cerebral em doentes com fibrilhação auricular em Portugal
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Luís Silva Miguel
Centro de Investigação Sobre Economia Portuguesa, Instituto Superior de Economia e Gestão, Lisboa, Portugal
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As a health economist, with a particular interest in the economic evaluation of drugs, I was pleased to read the article “Cost-effectiveness of rivaroxaban for stroke prevention in atrial fibrillation in the Portuguese setting” by Morais et al. in volume 33, issue 9, of the Journal.1

It is increasingly clear that as well as the criteria of efficacy, safety and quality that are required for market authorization, the cost-effectiveness of a drug should also be taken into consideration. This is essential to ensure the best use of resources and thus better health outcomes.

Of course, this objective can only be fully achieved if the medical community has access to studies published in journals of recognized scientific quality and prestige.

However, despite improvements over the last 15 years, a significant proportion of the medical community lacks the necessary tools to perform a critical analysis of a study's results or to identify factors that could affect them. It is thus essential that at least the main parameters used in a particular study should be explained in a transparent fashion.

As the lead author of the article “Economic evaluation of dabigatran for stroke prevention in patients with non-valvular atrial fibrillation”, published in volume 32, issue 7–8, of the Journal,2 I carried out a careful analysis of the results presented by Morais et al. Comparison between the two studies showed that the differences stem from the different financial costs assigned to monitoring patients under warfarin. As readers will naturally compare the two articles, I consider it essential that the authors of the cost-effectiveness study of rivaroxaban clearly specify this parameter.

I would also like to point out that there appears to be an error in Table 4 (“Cost-effectiveness results of base-case analysis”) of the article by Morais et al. In this table, the authors report the total costs for both drugs and separate costs for drug acquisition, drug administration, and event treatment. However, the sum of the latter does not equal the total.

Ethical disclosuresProtection of human and animal subjects

The authors declare that no experiments were performed on humans or animals for this investigation.

Confidentiality of data

The authors declare that no patient data appears in this article.

Right to privacy and informed consent

The authors declare that no patient data appears in this article.

Conflicts of interest

The author has no conflicts of interest to declare.

References
[1]
J. Morais, C. Aguiar, E. McLeod, et al.
Estudo de custo-efectividade de rivaroxabano para prevenção de acidente vascular cerebral em doentes com fibrilhação auricular em Portugal.
Rev Port Cardiol, 33 (2014), pp. 535-544
[2]
L.S. Miguel, E. Rocha, J. Ferreira.
Avaliação económica do dabigatrano na prevenção de acidentes vasculares cerebrais isquémicos em doentes com fibrilhação auricular não valvular.
Rev Port Cardiol, 32 (2013), pp. 557-565

Please cite this article as: Miguel LS. Comentário a estudo de custo-efetividade de rivaroxabano para prevenção de acidente vascular cerebral em doentes com fibrilhação auricular em Portugal. Rev Port Cardiol. 2015;34:705–706.

Copyright © 2015. Sociedade Portuguesa de Cardiologia
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