Dalteparin versus vitamin K antagonists for the prevention of recurrent venous thromboembolism in patients with cancer and renal impairment: a Canadian pharmacoeconomic analysis
| Autor: | Mark Crowther, Lesley G Shane, George Dranitsaris, Guillaume Feugère, Seth Woodruff |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
recurrence medicine.drug_class Economics Econometrics and Finance (miscellaneous) Population venous thromboembolism Low molecular weight heparin Subgroup analysis 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine dalteparin Randomized controlled trial law Internal medicine medicine cancer education low-molecular-weight heparin Original Research education.field_of_study Cost–utility analysis business.industry Health Policy Cancer medicine.disease Confidence interval Surgery ClinicoEconomics and Outcomes Research vitamin K antagonists 030220 oncology & carcinogenesis Relative risk business |
| Zdroj: | ClinicoEconomics and Outcomes Research: CEOR |
| ISSN: | 1178-6981 |
| Popis: | George Dranitsaris,1 Lesley G Shane,2 Mark Crowther,3 Guillaume Feugere,4 Seth Woodruff2 1Health Economic and Outcomes Research, Augmentium Pharma Consulting Inc, Toronto, ON, Canada; 2Pfizer Inc, New York, NY, USA; 3McMaster University, Hamilton, ON, 4Pfizer Canada, Montreal, QC, Canada Background: Patients with cancer are at increased risk of venous thromboembolism (VTE) and the risk is further elevated after a primary VTE. To reduce the risk of recurrent events, extended prophylaxis with vitamin K antagonists (VKA) is available for use. However, in a large randomized trial (Comparison of Low-Molecular-Weight Heparin versus Oral Anticoagulant Therapy for the Prevention of Recurrent Venous Thromboembolism in Patients with Cancer [CLOT]; Lee et al), extended duration dalteparin reduced the relative risk of recurrent VTE by 52% compared to VKA (p=0.002). A recent subgroup analysis of patients with moderate-to-severe renal impairment also revealed lower absolute VTE rates with dalteparin (3% vs. 17%; p=0.011). To measure the economic value of dalteparin as an alternative to VKA, a patient-level cost utility analysis was conducted from a Canadian perspective. Methods: Resource use data captured during the CLOT trial were extracted and linked to 2015 Canadian unit cost estimates. Health state utilities were then measured using the Time-Trade-Off technique in 24 randomly selected members of the general Canadian public to estimate the gains in quality-adjusted life years (QALYs). Results: For the entire CLOT trial population (n=676), the dalteparin group had significantly higher mean costs compared to the VKA group ($Can5,771 vs. $Can2,569; p |
| Databáze: | OpenAIRE |
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