الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
In the present time of growing demands on limited health care resources, assessment of the cost-effective¬ness of therapies is becoming increasingly necessary in Egyptian health care. Overall, the results of this analysis indicate that, from the perspective of the Egyptian health sector, addition of aspirin to warfarin is more effective and less costly than warfarin alone for patients with mechanical valve prostheses. This combined strategy could be adopted for patients to prevent the complications of mechanical valve prostheses.
The results are summarized as follows:
• There were fewer primary events in the warfarin plus aspirin arm than in the warfarin arm (1.4%/year; SD, 11.8, versus 4.8%/year; SD, 21.4) and showed a significant difference in event rate among the arms (P value of 0.05).
• The mean QALYs score in the warfarin plus aspirin arm was higher, but the difference did not reach conventional levels of statistical significance (P value of 0.116).
• Patients in the warfarin plus aspirin group had a significant longer duration of protection against the first event. The overall difference in effect yielded a P value of 0.046.
• Event costs were lower in the warfarin plus aspirin arm, primarily driven by the difference in primary events.
• Physician visit costs were slightly higher in the warfarin plus aspirin arm, and INR visit costs were considerably greater, as expected.
• Total costs per patient were lower in the warfarin plus aspirin group than in the warfarin group ($310 versus $554) and showed a significant difference between groups (P=0.049).
• The warfarin plus aspirin arm was associated with lower costs and a higher QALYs score than was the warfarin arm, which yielded ICER of -4603 per QALY gained for warfarin plus aspirin, indicating that the combined therapy (warfarin plus aspirin) is the dominant treatment option.