The cost implications of dabigatran in patients with myocardial injury after non-cardiac surgery
| Autor: | Andre Lamy, Wojciech Szczeklik, Jessica Vincent, Sadeesh Srinathan, Emmanuelle Duceppe, Maria Graza Franzosi, Joel L. Parlow, Wesley Tong, Denis Xavier, Rajibul Mian, P. J. Devereaux, Bruce M Biccard, Christian S. Meyhoff |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
education.field_of_study business.industry medicine.medical_treatment Population General Medicine medicine.disease Placebo Confidence interval Dabigatran Pharmacotherapy Amputation Emergency medicine Medicine Pharmacology (medical) Myocardial infarction Cardiology and Cardiovascular Medicine business education Stroke health care economics and organizations medicine.drug |
| Popis: | The Management of Myocardial Injury after Non-Cardiac Surgery (MANAGE) trial demonstrated that dabigatran 110 mg twice daily was more effective than placebo in preventing the primary composite outcome of vascular mortality, non-fatal myocardial infarction, non-hemorrhagic stroke, peripheral arterial thrombosis, amputation and symptomatic venous thromboembolism in patients with myocardial injury after non-cardiac surgery (MINS). The cost implications of dabigatran for this population are unknown but are important given the significant clinical implications. Hospitalized events, procedures, and study and non-study medications were documented. We applied Canadian unit costs to healthcare resources consumed for all patients in the trial, and calculated the average cost per patient in Canadian dollars for the duration of the study (median follow-up of 16 months). A sensitivity analysis was performed using only Canadian patients, and subgroup analyses were also conducted. The total study cost for the dabigatran group was $9985 per patient, compared with $10,082 for placebo, a difference of − $97 (95% confidence interval [CI] − $2128 to $3672). Savings arising from fewer clinical events and procedures in the dabigatran 110 mg twice-daily group were enough to offset the cost of the study drug. In Canadian patients, the difference was $250 (95% CI −$2848 to $4840). Both differences were considered cost neutral. Dabigatran 110 mg twice daily was cost saving or cost neutral in many subgroups that were considered. Dabigatran 110 mg twice daily was cost neutral for patients in the MANAGE trial. Our cost findings support the use of dabigatran 110 mg twice daily in patients with MINS. ClinicalTrials.gov identifier number NCT01661101. |
| Databáze: | OpenAIRE |
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