Dabigatran Compared With Warfarin for Stroke Prevention in Atrial Fibrillation

TO THE EDITOR:

In their recent article on the cost-effectiveness of dabigatran versus warfarin, Freeman and colleagues (1) did not account for some of the highest costs associated with warfarin administration. Each time that prothrombin time is measured, the logistics involved cost money. Patients must travel to the laboratory to have blood drawn, or family members must take them. If patients are homebound, the cost of visiting nurses is high.

The authors also did not account for the costs of prothrombin time measurement for physicians, patients, and caregivers. For example, when one of my patients undergoes measurement of prothrombin time, ...