Factors influencing dabigatran or warfarin medication persistence in patients with nonvalvular atrial fibrillation

J Comp Eff Res. 2018 Jul;7(7):685-691. doi: 10.2217/cer-2017-0081. Epub 2018 May 29.


Factors influencing differences in persistence between dabigatran and warfarin in patients with nonvalvular atrial fibrillation (NVAF) remain unclear.

Aim: Compare differences in persistence between new dabigatran and warfarin users in patients newly diagnosed with NVAF, adjusting for sociodemographics, clinical characteristics, patient out-of-pocket cost and other covariates.

Methods: A retrospective matched-cohort study was conducted using a US claims database of Medicare and commercially insured patients with NVAF aged≥ 18 years. Persistence and monthly out-of-pocket costs for dabigatran or warfarin were calculated and adjusted for covariates using Cox proportional hazard models.

Results & conclusion: Unadjusted persistence was significantly lower among dabigatran users (n = 1025) compared with matched warfarin users (38 vs 46%). Adjusting for covariates rendered this difference insignificant (hazard ratio = 0.930).

Keywords: dabigatran; nonvalvular atrial fibrillation; out of pocket cost; persistence; warfarin.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anticoagulants / therapeutic use*
  • Antithrombins / economics
  • Antithrombins / therapeutic use
  • Atrial Fibrillation / drug therapy*
  • Atrial Fibrillation / economics
  • Cohort Studies
  • Costs and Cost Analysis
  • Dabigatran / economics
  • Dabigatran / therapeutic use*
  • Databases, Factual
  • Drug Costs
  • Female
  • Humans
  • Male
  • Medicare / economics
  • Medication Adherence
  • Proportional Hazards Models
  • Retrospective Studies
  • Stroke / economics
  • Stroke / prevention & control
  • United States
  • Warfarin / economics
  • Warfarin / therapeutic use*


  • Anticoagulants
  • Antithrombins
  • Warfarin
  • Dabigatran