A geospatial approach and model to minimize the costs of anticoagulation therapy from the atrial fibrillation patient’s point of view

Authors: Mikko Pyykönen*, University of Eastern Finland, Tiina Laatikainen, University of Eastern Finland, National Institute for Health and Welfare, Markku Tykkyläinen, University of Eastern Finland
Topics: Medical and Health Geography, Geographic Information Science and Systems, Spatial Analysis & Modeling
Keywords: Geospatial model, Atrial fibrillation, NOAC, Warfarin, Cost-effectiviness, Network analysis
Session Type: Paper
Day: 4/5/2019
Start / End Time: 9:55 AM / 11:35 AM
Room: Marshall South, Marriott, Mezzanine Level
Presentation File: No File Uploaded


This paper focuses on comparing the cost-effectiveness of two atrial fibrillation (AF) therapies, warfarin and NOAC, applying a geospatial model which divides the service areas of health care centers into two classes based on the spatial cost-effectiveness of these therapies. The total cost of warfarin therapy consists of drug expenses and time and traveling costs to follow-up monitoring in the lab and in NOAC therapy, the total cost consists of only drug expenses. The model takes account of the all travel modes, the main age groups of AF patients and the frequency of monitoring visits. The study area is North Karelia, New Jersey–size region, in Finland. Early results show that the NOAC therapy can be the cheapest option for patients further from health care centers when patients are using more expensive travel modes. In Finland, the new reimbursement for AF patients have reduced the drug cost of NOAC which means that the out-of-pocket cost between therapies has narrowed. However, the patients have not adopted NOAC therapy there where it is the cheapest as much as expected and thus the adoption of NOAC has delayed.

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