Health-care Cost Impact of Continued Anticoagulation With Rivaroxaban vs Aspirin for Prevention of Recurrent Symptomatic VTE in the EINSTEIN-CHOICE Trial Population
Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:154 |
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| Enthalten in: |
Chest - 154(2018), 6 vom: 01. Dez., Seite 1371-1378 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Wells, Philip S [VerfasserIn] |
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| Links: |
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| Themen: |
9NDF7JZ4M3 |
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| Anmerkungen: |
Date Completed 24.09.2019 Date Revised 25.09.2019 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.chest.2018.08.1059 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM288387058 |
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| 100 | 1 | |a Wells, Philip S |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Health-care Cost Impact of Continued Anticoagulation With Rivaroxaban vs Aspirin for Prevention of Recurrent Symptomatic VTE in the EINSTEIN-CHOICE Trial Population |
| 264 | 1 | |c 2018 | |
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| 500 | |a Date Completed 24.09.2019 | ||
| 500 | |a Date Revised 25.09.2019 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a anticoagulants | |
| 650 | 4 | |a aspirin | |
| 650 | 4 | |a cost comparison | |
| 650 | 4 | |a economic analysis | |
| 650 | 4 | |a extended treatment | |
| 650 | 4 | |a recurrent VTE | |
| 650 | 4 | |a rivaroxaban | |
| 650 | 7 | |a Anticoagulants |2 NLM | |
| 650 | 7 | |a Rivaroxaban |2 NLM | |
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| 650 | 7 | |a Aspirin |2 NLM | |
| 650 | 7 | |a R16CO5Y76E |2 NLM | |
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| 700 | 1 | |a Lensing, Anthonie W A |e verfasserin |4 aut | |
| 700 | 1 | |a Haskell, Lloyd |e verfasserin |4 aut | |
| 700 | 1 | |a Levitan, Bennett |e verfasserin |4 aut | |
| 700 | 1 | |a Laliberté, François |e verfasserin |4 aut | |
| 700 | 1 | |a Ashton, Veronica |e verfasserin |4 aut | |
| 700 | 1 | |a Xiao, Yongling |e verfasserin |4 aut | |
| 700 | 1 | |a Lejeune, Dominique |e verfasserin |4 aut | |
| 700 | 1 | |a Crivera, Concetta |e verfasserin |4 aut | |
| 700 | 1 | |a Lefebvre, Patrick |e verfasserin |4 aut | |
| 700 | 1 | |a Zhao, Qi |e verfasserin |4 aut | |
| 700 | 1 | |a Yuan, Zhong |e verfasserin |4 aut | |
| 700 | 1 | |a Schein, Jeff |e verfasserin |4 aut | |
| 700 | 1 | |a Prandoni, Paolo |e verfasserin |4 aut | |
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