Impact of comparative effectiveness research on Medicare coverage of direct oral anticoagulants
Publication: Journal of Comparative Effectiveness Research
Abstract
Aim: To evaluate the association of comparative effectiveness research with Medicare coverage of direct oral anticoagulants. Materials & methods: A literature review for direct oral anticoagulants was conducted from 2011 to 2017. Monthly prescription drug plan and formulary files (n = 28) were used to conduct change-point analysis and assess each outcome variable. Results: Up to 2013, studies showed that dabigatran was more effective than rivaroxaban. In 2015, apixaban was shown to be the safest and most effective drug in comparison with all direct oral anticoagulants. In 2016–2017, dabigatran and apixaban were shown to have similar efficacy. Approximately 75% of plans covered dabigatran under tier 3 until 2015. From 2011 to 2017, less than 30% of plans required prior authorizations, 50% imposed quantity limits and mean copayment was lowest for rivaroxaban. Conclusion: Consistent with comparative effectiveness research, Medicare plans covered apixaban more favorably and edoxaban less favorably. However, discrepancies in comparative effectiveness research translation were found for rivaroxaban and dabigatran.
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PubMed: 36065839
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© 2022 Future Medicine Ltd.
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Received: 23 December 2021
Accepted: 8 August 2022
Published online: 6 September 2022
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Holcomb Awards Committee, Butler University
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Impact of comparative effectiveness research on Medicare coverage of direct oral anticoagulants. (2022) Journal of Comparative Effectiveness Research. DOI: 10.2217/cer-2021-0307
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