Cost Effectiveness Analysis Rivaroxaban Plus Aspirin Versus Aspirin Alone in Treatment Cardiovascular Diseases: A Systematic Review

Background: Cardiovascular diseases (CVDs) are one of the chronic diseases and the leading cause of death worldwide. More people die from CVDs worldwide than from any other cause each year. The effects of CVDs are not limited to mortality and morbidity but also have important health and economic outcomes.

Methods: This was a systematic review that evaluated the economic evaluation of rivaroxaban plus aspirin compared with aspirin alone for the treatment of CVDs. The present study reviewed articles that performed a complete economic evaluation, including cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis related to the economic evaluation of rivaroxaban compared to enoxaparin for knee replacement patients during the years 2007 and 2023. In order to find relevant studies, databases including Pubmed, Web of Science, Embase, Scopus, Economic Evaluations Database, and Proquest were searched. Inclusion criteria included Studies that carried out a complete economic evaluation including cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis in relation to the economic evaluation of rivaroxaban plus aspirin compared to aspirin alone for CVD patients, economic evaluation studies carried out using decision analysis models based on the economic evaluation approach, full-text studies, English studies, and were studies published between 2007 and 2023. Exclusion criteria also included partial economic evaluation (such as effectiveness evaluation, cost evaluation, and quality of life evaluation), studies of low methodological quality based on the CHEERS checklist, non-English studies and all protocols, conference abstracts, and letters-to-the-editor.

Results: After searching various databases, all retrieved articles were entered into EndNote software, and duplicates were removed. The remaining studies were reviewed independently by two relevant researchers. At this stage, preferred reporting items for systematic reviews (PRISMA) were used to retrieve the final articles. Out of 1048 studies, nine studies met the inclusion criteria. The economic evaluation studies included in the present study were conducted between 2018 and 2023. Cost-effectiveness analysis (CEA) was used in all studies.

Conclusion: The findings of the present study showed that rivaroxaban plus aspirin is more cost-effective than aspirin alone in the patient with CVDs, But to generalize the results to other countries of the world, more studies are needed.