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June 15, 2005

Cost-effectiveness of Ximelagatran for Stroke Prevention

JAMA. 2005;293(23):2860-2861. doi:10.1001/jama.293.23.2860

To the Editor: We would like to raise concerns about a possible bias in the cost-effectiveness analysis by Drs O’Brien and Gage.1 To calculate quality-adjusted survival, the authors used results of a previous survey of 83 patients with atrial fibrillation,2 which estimated the mean utility of warfarin therapy to be 0.987 and the mean utility of aspirin therapy to be 0.998. We believe that the utility of warfarin therapy may be overestimated.

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