The Financial Burden of Aspirin versus Oral Factor Xa Inhibitors for Thromboprophylaxis Following Total Knee Arthroplasty
Copyright © 2023 Elsevier Inc. All rights reserved..
BACKGROUND: Aspirin and oral factor Xa inhibitor thromboprophylaxis regimens are associated with similarly low rates of venous thromboembolism following total knee arthroplasty (TKA). However, the rate of prosthetic joint infection (PJI) is lower with aspirin use. This study aimed to compare the cost differential between aspirin and factor Xa inhibitor thromboprophylaxis with respect to PJI management.
METHODS: We used previously published rates of PJI following aspirin and factor Xa inhibitor thromboprophylaxis in primary TKA patients at a single, large institution. Prices for individual drugs were obtained from our hospital's pharmacy service. The cost of PJI included that of 2-stage septic revision, with or without the cost of 1-year follow-up. National data were obtained to determine annual projected TKA volume.
RESULTS: The per-patient costs associated with a 28-day course of aspirin versus factor Xa inhibitor thromboprophylaxis were $17.36 and $3,784.20, respectively. Including cost of follow-up, per-patient costs for a 28-day course of aspirin versus factor Xa inhibitors increased to $73,358.76 and $77,125.60, respectively. The weighted average per-patient costs for a 28-day course were $237.38 and $4,370.93, respectively. The annual cost difference could amount to over $14.1 billion in the United States by 2040.
CONCLUSIONS: The per-patient cost associated with factor Xa inhibitor thromboprophylaxis is as much as 1,980.6% higher than that of an aspirin regimen due to increased costs of primary treatment, differential PJI rates, and high costs of management. In an era of value-based care, the use of aspirin is associated with major cost advantages.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:39 |
|---|---|
| Enthalten in: |
The Journal of arthroplasty - 39(2024), 4 vom: 13. März, Seite 935-940 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Bergstein, Victoria E [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 15.03.2024 Date Revised 15.03.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.arth.2023.10.017 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM363511431 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM363511431 | ||
| 003 | DE-627 | ||
| 005 | 20240315232821.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.arth.2023.10.017 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1330.xml |
| 035 | |a (DE-627)NLM363511431 | ||
| 035 | |a (NLM)37858709 | ||
| 035 | |a (PII)S0883-5403(23)01035-5 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Bergstein, Victoria E |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The Financial Burden of Aspirin versus Oral Factor Xa Inhibitors for Thromboprophylaxis Following Total Knee Arthroplasty |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 15.03.2024 | ||
| 500 | |a Date Revised 15.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Aspirin and oral factor Xa inhibitor thromboprophylaxis regimens are associated with similarly low rates of venous thromboembolism following total knee arthroplasty (TKA). However, the rate of prosthetic joint infection (PJI) is lower with aspirin use. This study aimed to compare the cost differential between aspirin and factor Xa inhibitor thromboprophylaxis with respect to PJI management | ||
| 520 | |a METHODS: We used previously published rates of PJI following aspirin and factor Xa inhibitor thromboprophylaxis in primary TKA patients at a single, large institution. Prices for individual drugs were obtained from our hospital's pharmacy service. The cost of PJI included that of 2-stage septic revision, with or without the cost of 1-year follow-up. National data were obtained to determine annual projected TKA volume | ||
| 520 | |a RESULTS: The per-patient costs associated with a 28-day course of aspirin versus factor Xa inhibitor thromboprophylaxis were $17.36 and $3,784.20, respectively. Including cost of follow-up, per-patient costs for a 28-day course of aspirin versus factor Xa inhibitors increased to $73,358.76 and $77,125.60, respectively. The weighted average per-patient costs for a 28-day course were $237.38 and $4,370.93, respectively. The annual cost difference could amount to over $14.1 billion in the United States by 2040 | ||
| 520 | |a CONCLUSIONS: The per-patient cost associated with factor Xa inhibitor thromboprophylaxis is as much as 1,980.6% higher than that of an aspirin regimen due to increased costs of primary treatment, differential PJI rates, and high costs of management. In an era of value-based care, the use of aspirin is associated with major cost advantages | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a cost-effectiveness | |
| 650 | 4 | |a economics | |
| 650 | 4 | |a financial modeling | |
| 650 | 4 | |a prosthetic joint infection | |
| 650 | 4 | |a thromboprophylaxis | |
| 650 | 4 | |a total knee arthroplasty | |
| 650 | 7 | |a Anticoagulants |2 NLM | |
| 650 | 7 | |a Aspirin |2 NLM | |
| 650 | 7 | |a R16CO5Y76E |2 NLM | |
| 650 | 7 | |a Factor Xa Inhibitors |2 NLM | |
| 650 | 7 | |a Fibrinolytic Agents |2 NLM | |
| 650 | 7 | |a Antithrombin III |2 NLM | |
| 650 | 7 | |a 9000-94-6 |2 NLM | |
| 700 | 1 | |a Taylor, Walter L |c 4th |e verfasserin |4 aut | |
| 700 | 1 | |a Weinblatt, Aaron I |e verfasserin |4 aut | |
| 700 | 1 | |a Lesser, Lauren C |e verfasserin |4 aut | |
| 700 | 1 | |a Long, William J |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The Journal of arthroplasty |d 1995 |g 39(2024), 4 vom: 13. März, Seite 935-940 |w (DE-627)NLM012629375 |x 1532-8406 |7 nnns |
| 773 | 1 | 8 | |g volume:39 |g year:2024 |g number:4 |g day:13 |g month:03 |g pages:935-940 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.arth.2023.10.017 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 39 |j 2024 |e 4 |b 13 |c 03 |h 935-940 | ||