Cost Effectiveness of Tinzaparin Sodium Versus Unfractionated Heparin in the Treatment of Proximal Deep Vein Thrombosis

Jaime, J.; Getsios, Denis; Caro, Ingrid; O’Brien, Judith A.

doi:10.2165/00019053-200220090-00003

Cited by 21 publications

(22 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Analyses overview: Published cost-effectiveness models [20][21][22][23][24] were used, in combination with expert opinion, to inform the structure of the model. The analyses were conducted from the societal perspective and only direct costs were included.…”

Section: Methodsmentioning

confidence: 99%

Economic Analysis of Rivaroxaban for the Treatment and Long-Term Prevention of Venous Thromboembolism in Portugal

Santos¹,

Pereira²,

McLeod³

et al. 2014

Acta Med Port

View full text Add to dashboard Cite

Introduction: Venous thromboembolism is a burden on healthcare systems. The aim of this analysis was to project the long-term costs and outcomes for rivaroxaban compared to standard of care (enoxaparin/warfarin) in Portugal for the treatment and secondary prevention of venous thromboembolism. Material and Methods: A Markov model was developed using event rates extracted from the EINSTEIN trials supplemented with literature-based estimates of longer-term outcomes. Core outcomes included per patient costs and quality-adjusted life years reported separately per treatment arm and incrementally, as well as cost per quality-adjusted life years gained. The deep vein thrombosis and pulmonary embolism indications were analysed separately. The analyses were conducted from the Portuguese societal perspective and over a 5-year time horizon. Costs and outcomes were discounted at a 5% annual rate. Several scenario analyses were undertaken to explore the impact on results of varying key modeling assumptions. Results: Rivaroxaban treatment was associated with cost-savings for the treatment of deep vein thrombosis and was both cost-saving and more effective for the treatment of pulmonary embolism, compared with enoxaparin/warfarin. Discussion: The results of the sensitivity and scenario analyses further supported that rivaroxaban is a cost-effective alternative to standard of care treatment. The use of an expert panel to derive some input values and the lack of Portuguese specific utilities were the main limitations. Conclusion: Rivaroxaban represents an efficient alternative to using enoxaparin/warfarin in Portugal, as it's associated with lower costs (for both indications) and greater quality adjusted life years (for the pulmonary embolism indication). Keywords: Cost-Benefit Analysis; Venous Thrombosis; Pulmonary Embolism; Rivaroxaban; Venous Thromboembolism. O tromboembolismo venoso representa uma carga substancial para os sistemas de saúde. O objectivo foi estimar os resultados clínicos e económicos a longo-prazo associados a rivaroxabano relativamente à prática clínica (enoxaparina/varfarina) no tratamento e prevenção secundária de tromboembolismo venoso em Portugal. Material e Métodos: Foi desenvolvido um modelo de Markov baseado nos ensaios clínicos EINSTEIN e dados da literatura para complicações a longo-prazo. Foram avaliados custos e anos de vida ajustados pela qualidade de vida totais e incrementais e rácio custo-efectividade incremental. As indicações trombose venosa profunda e embolismo pulmonar foram analisados separadamente. Adoptou-se a perspectiva da sociedade portuguesa e um horizonte temporal de cinco anos. Aplicou-se uma taxa de actualização de cinco por cento para custos e consequências. Foram desenvolvidas análises de sensibilidade e diversas análises de cenário para avaliação da variação dos resultados em função de determinados pressupostos. Resultados: Rivaroxabano está associado a menores custos na trombose venosa profunda e constitui uma alternativa associada a menores custos e a maior eficácia ...

show abstract

Section: Methodsmentioning

confidence: 99%

Economic Analysis of Rivaroxaban for the Treatment and Long-Term Prevention of Venous Thromboembolism in Portugal

Santos¹,

Pereira²,

McLeod³

et al. 2014

Acta Med Port

View full text Add to dashboard Cite

show abstract

“…The cost-effectiveness of treating VTE with LMWH rather than UFH has been assessed using several models [23][24][25][26][27][28][29][30][31][32][33][34][35][36]. Although adopting different methodologies, the studies -the first set in Canada and the latter three set in the USA -have come to very similar conclusions.…”

Section: Pharmacoeconomic Modelsmentioning

confidence: 99%

“…The most recent pharmacoeconomic model compared a specific LMWH, tinzaparin, with UFH. Health outcomes improved with tinzaparin and there were long-term savings of between approximately US$500 and 5000 per patient ($US 1999) (TABLE 3) [26].…”

Section: Pharmacoeconomic Modelsmentioning

confidence: 99%

“…While key effectiveness inputs in all of the models came from short-term clinical trials, two of the models evaluated outcomes over much longer periods, estimating long-term recurrence of VTE, appearance of postphlebitic syndrome, survival and quality-adjusted survival [24,26]. Data for the long-term predictions, and utilities used to calculate quality-adjusted life years (QALYs) came from the same sources in both analyses.…”

Section: Effectiveness Datamentioning

confidence: 99%

“…In both economic evaluations, DVT was assumed to have an effect on health utilities only if patients developed postphlebitic syndrome or died [30]. Although the methodologies used to incorporate these long-term data were different (e.g., one study used Swedish survival data directly, while the other applied relative risk results from the Swedish study to US life expectancy data), both assumed that the long-term risks of these events were not affected by the initial treatment choice of either UFH or LMWH [24,26]. This assumption was tested in one of the studies, which was found to have a large impact on cost-effectiveness outcomes.…”

Section: Effectiveness Datamentioning

confidence: 99%

See 2 more Smart Citations

Economic assessments of low molecular weight heparin in venous thromboembolism

Ward¹,

Getsios²,

O’Brien³

et al. 2004

Expert Review of Pharmacoeconomics & Outcomes Research

Self Cite

View full text Add to dashboard Cite

Heparin is the treatment of choice for managing patients in the acute phase of venous thromboembolism. While the drug cost of low molecular weight heparins may be greater than unfractionated heparin, its use makes outpatient treatment possible for most patients and allows an earlier discharge from hospital for those requiring inpatient care. Pharmacoeconomic studies and meta-analyses have compared disease management with unfractionated heparin versus the low molecular weight heparins. The results indicate that low molecular weight heparins are the dominant choice. Health outcomes are improved while the overall cost of managing venous thromboembolism is reduced. Additional research is required to examine the relative efficacy and safety of each of the low molecular weight heparin presentations, adherence in the outpatient setting and the impact of acute treatment choices on long-term outcomes such as recurrence, post-thrombotic syndrome and quality of life.

show abstract

The economic burden of supportive care of cancer patients

Elting

Shih

2004

Supportive Care in Cancer

View full text Add to dashboard Cite

show abstract

Cost Effectiveness of Tinzaparin Sodium Versus Unfractionated Heparin in the Treatment of Proximal Deep Vein Thrombosis

Abstract: Tinzaparin sodium leads to better health outcomes and substantial economic savings compared with UFH treatment when all management costs are considered.

Cited by 21 publications

References 42 publications

Economic Analysis of Rivaroxaban for the Treatment and Long-Term Prevention of Venous Thromboembolism in Portugal

Economic Analysis of Rivaroxaban for the Treatment and Long-Term Prevention of Venous Thromboembolism in Portugal

Economic assessments of low molecular weight heparin in venous thromboembolism

The economic burden of supportive care of cancer patients

Contact Info

Product

Resources

About