Purpose: To assess costs and healthcare resource utilization (HCRU) associated with the use of idarucizumab for the reversal of dabigatran and andexanet alfa for the reversal of direct oral Factor Xa inhibitors. Methods: This retrospective study utilizing Premier Healthcare Database (PHD) included patients aged ≥18 years on direct oral anticoagulants (DOACs) who experienced life-threatening bleeds, discharged from the hospital during 5/1/2018–6/30/2019, and received idarucizumab or andexanet alfa. Inverse of treatment probability weighting (IPTW) method was used to balance patient and clinical characteristics between treatment cohorts. Results: Idarucizumab patients were older than andexanet alfa patients (median age 81 vs 77 years; p < 0.001), and less likely to experience intracranial hemorrhage (ICH) (37.1%vs 73.8%; p = 0.001). After IPTW adjustment, idarucizumab patients incurred lower mean total hospital costs ($30,413 ± $33,028 vs $44,477 ± $30,036; p < 0.001),and mean intensive care unit (ICU) cost ($25,114 ± $30,433 vs $43,484 ± $29,335; p < 0.001). Conclusions: Anticoagulant reversal therapy with idarucizumab was associated with significantly lower adjusted mean total hospital and ICU costs compared with andexanet alfa. However, a higher prevalence of ICH bleeds was noted in the andexanet alfa group. Trial Registration: Not applicable.

目的：评估与使用 idarucizumab 逆转达比加群和andexanet alfa 逆转直接口服 Xa 因子抑制剂相关的成本和医疗资源利用率 (HCRU)。方_接受了idarucizumab或andexanet alfa。使用逆治疗概率加权 (IPTW) 方法来平衡治疗组之间的患者和临床特征。结果：Idarucizumab 患者的年龄大于 andexanet alfa 患者（中位年龄 81 岁 vs 77 岁；p < 0.001），发生颅内出血 (ICH) 的可能性较小（37.1% vs 73.8%；p = 0.001）。IPTW 调整后，idarucizumab 患者的平均住院总费用较低（30,413 ± 33,028 美元 vs 44,477 ± 30,036 美元；p < 0.001）和重症监护病房 (ICU) 平均费用（25,114 ± 30,433 美元 vs 43,484 ± 29,335 美元； p < 0.001）。结论：与 andexanet alfa 相比，使用 idarucizumab 进行抗凝逆转治疗与调整后的平均总住院和 ICU 成本显着降低相关。然而，andexanet alfa 组的 ICH 出血发生率较高。试用注册：不适用。