Health-care Cost Impact of Continued Anticoagulation With Rivaroxaban vs Aspirin for Prevention of Recurrent Symptomatic VTE in the EINSTEIN-CHOICE Trial Population
| Autor: | Concetta Crivera, Paolo Prandoni, François Laliberté, Zhong Yuan, Yongling Xiao, Philip S. Wells, Patrick Lefebvre, Martin H. Prins, Dominique Lejeune, Qi Zhao, Bennett Levitan, Lloyd Haskell, Jeff Schein, Veronica Ashton, Jan Beyer-Westendorf, Anthonie W. A. Lensing |
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| Přispěvatelé: | RS: CAPHRI - R5 - Optimising Patient Care, Epidemiologie, MUMC+: KIO Kemta (9) |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
030204 cardiovascular system & hematology Critical Care and Intensive Care Medicine 0302 clinical medicine Secondary Prevention 030212 general & internal medicine DEEP-VEIN THROMBOSIS rivaroxaban health care economics and organizations Randomized Controlled Trials as Topic ORAL ANTICOAGULANTS Aspirin education.field_of_study Health Care Costs Middle Aged Pulmonary embolism Female Drug Monitoring Cardiology and Cardiovascular Medicine medicine.drug Pulmonary and Respiratory Medicine medicine.medical_specialty anticoagulants cost comparison aspirin Population Hemorrhage EXTENDED TREATMENT ALL-CAUSE WARFARIN economic analysis recurrent VTE 03 medical and health sciences Cost Savings ECONOMIC BURDEN medicine Humans education Rivaroxaban VENOUS THROMBOEMBOLISM Dose-Response Relationship Drug business.industry Warfarin medicine.disease MODEL Emergency medicine Managed care Per patient per month business Pulmonary Embolism Venous thromboembolism |
| Zdroj: | Chest, 154(6), 1371-1378. Elsevier |
| ISSN: | 0012-3692 |
| Popis: | BACKGROUND: Using data from the Reduced-Dose Rivaroxaban in the Long-Term Prevention of Recurrent Symptomatic Venous Thromboembolism (EINSTEIN-CHOICE) trial, this study assessed cost impact of continued anticoagulation therapy with rivaroxaban vs aspirin.METHODS: Total health-care costs (2016 USD) associated with rivaroxaban and aspirin were calculated as the sum of clinical event costs and drug costs from a US managed care perspective. Clinical event costs were calculated by multiplying event rate by cost of care. One-year Kaplan-Meier clinical event rates for recurrent pulmonary embolism, recurrent DVT, all-cause mortality, and bleeding were obtained from EINSTEIN-CHOICE. Cost of care was determined by literature review. Drug costs were the product of drug price (wholesale acquisition cost) and treatment duration. A one-way sensitivity analysis was conducted.RESULTS: Rivaroxaban users had lower per patient per month (PPPM) clinical event costs compared with aspirin users ($123, $243, and $381 for rivaroxaban 10 mg, rivaroxaban 20 mg, and aspirin, respectively). However, vs aspirin, PPPM total health-care costs were $24 higher for patients treated with rivaroxaban 10 mg ($143 higher for rivaroxaban 20 mg) due to higher cost of rivaroxaban. With a 15% discount for rivaroxaban 10 mg, the lower cost of clinical events for the rivaroxaban-treated patients more than fully offset the higher drug costs, and yielded a $19 lower total health-care cost.CONCLUSIONS: Continued therapy with rivaroxaban 10 and 20 mg vs aspirin was associated with lower clinical event costs but higher total health-care costs; with a 15% drug discount rivaroxaban 10 mg had lower total health-care costs than aspirin. |
| Databáze: | OpenAIRE |
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