de Jong LA, Groeneveld J, Stevanovic J, et al. - Researchers incorporated the available data both from RCT and real-world analyses of all non-vitamin K antagonists (VKAs) oral anticoagulants (NOACs) into one integrative previously published model, in order to determine the cost-effectiveness of the NOACs apixaban vs other NOACs (dabigatran, edoxaban and rivaroxaban) and VKA, for stroke prevention in patients with atrial fibrillation. They updated the model to the current Dutch healthcare situation. The network meta-analysis suggests apixaban vs VKA as cost-effective (€3,506 per quality-adjusted life-year) and that it was dominant (cost-saving and more effective) over dabigatran 110 mg, dabigatran 150 mg, edoxaban, and rivaroxaban. Real-world data suggest apixaban as dominant over all other anticoagulants. Findings thereby support apixaban as usually cost-effective or even cost-saving (less costly and more effective) when compared with VKA and other NOACs in the overall population of patients with atrial fibrillation.