Preview

Meditsinskiy sovet = Medical Council

Advanced search

Pharmacoeconomic evaluation of treating acute venous thromboembolism with rivaroxaban in the inpatient setting

https://doi.org/10.21518/2079-701X-2014-8-18-23

Abstract

Cost reduction associated with the use of rivaroxaban compared with the enoxaparin + warfarin combination for for deep vein thrombosis and pulmonary thromboembolism when treated in the inpatient setting. The choice of the cost reduction method is conditioned by the evidence from the randomized controlled studies EINSTEIN DVT and EINSTEIN PE, stating that rivaroxaban is no less effective compared with enoxaparin in combination with warfarin. The difference in the cost of the drugs is calculated from the healthcare perspective taking into account the risk of major bleeding. The price values were sourced from public procurement tenders (zakupki.gov.ru) in quarters I-IV 2013 and quarter I 2014. Costs associated with the treatment of major bleeding were defined on the basis of the obligatory medical insurance rates for Moscow in 2013. The authors demonstrated that use of rivaroxaban compared with enoxaparin and warfarin results in cost savings for the medicinal treatment of DVT and PTE in the amount of 2,020.71 and 3,353.35 rubles per patient, respectively. The revealed pattern is resistant to real-life fluctuations in prices for medicines.

About the Authors

MV Avksentyeva
Center for Technology Assessment in Healthcare, Institute of Applied Economic Research of the RANEPA, Department of Public Health and Preventive Medicine, First Moscow State Medical University named after I.M. Sechenov, Moscow
Russian Federation


OV Shatalova
Department of Clinical Pharmacology and Intensive Therapy with Clinical Pharmacology Courses, school of postgraduate medical education, Department of Clinical Allergology, school of postgraduate medical education, Volgograd State Medical University, Russian Ministry of Health
Russian Federation


References

1. White RH. The epidemiology of venous thromboembolism. Circulation, 2003, Jun. 17; 107 (23 Suppl. 1): I4-I8.

2. Oger E. Incidence of venous thromboembolism: a community-based study in Western France. Thromb Haemost, 2000, 83: 65760.

3. Spencer FA, Emery C, Lessard D, et al. The Worcester Venous Thromboembolism study: a population-based study of the clinical epidemiology of venous thromboembolism. J Gen Intern Med, 2006, 21: 722-7.

4. Groce JB. Initial management of deep venous thrombosis in the outpatient setting. American Journal of Health-System Pharmacy, 2008, May, 1; 65 (9): 866-74.

5. Merli G, Ferrufino C, Lin J, Hussein M, Battleman D. Hospital-based costs associated with venous thromboembolism treatment regimens. Journal of Thrombosis & Haemostasis, 2008, Jul, 6 (7): 1077-86.

6. Kearon C, Akl EA, Comerota AJ et al. Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2012, 141: e419S-e494S.

7. Российские клинические рекомендации по диагностике, лечению и профилактике венозных тромбоэмболических осложнений. Флебология, 2010, 4: 3-37.

8. The EINSTEIN Investigators. Oral rivaroxaban for symptomatic venous thromboembolism. N Engl J Med, 2010, 363: 2499-2510.

9. The EINSTEIN-PE Investigators. Oral rivaroxaban for the treatment of symptomatic pulmonary embolism. N Engl J Med, 2012, 366: 1287-1297.

10. Romualdi E, Donadini MP, Ageno W. Oral rivaroxaban after symptomatic venous thromboembolism: the continued treatment study (EINSTEIN-extension study). Expert Rev Cardiovasc Ther., 2011, Jul, 9 (7): 841-4.

11. Prins MH et al. Oral rivaroxaban versus standard therapy for the treatment of symptomatic venous thromboembolism: a pooled analysis of the EINSTEIN-DVT and PE randomized studies. Thrombosis Journal, 2013, 11: 21.

12. Московский городской фонд обязательного медицинского страхования [электронный ресурс]. Тарифы на медицинские услуги. URL: http://www.mgfoms.ru/?page_id=5198

13. Lefebvre P, Coleman CI, Bookhart BK, Wang ST, Mody SH, Tran KN, Zhuo DY, Huynh L, Nutescu EA. Cost-effectiveness of rivaroxaban compared with enoxaparin plus a vitamin K antagonist for the treatment of venous thromboembolism. J Med Econ., 2014, Jan., 17 (1): 52-64.

14. National Institute for Health and Clinical Excellence. Rivaroxaban for the treatment of deep vein thrombosis and prevention of recurrent deep vein thrombosis and pulmonary embolism. July 2012.

15. URL: http://www.nice.org.uk/guidance/ta261/resources/guidance-rivaroxaban-for-the-treatment-of-deep-vein-thrombosis-and-prevention-of-recurrent-deep-vein-thrombosis-and-pulmonary-embolism-pdf


Review

For citations:


Avksentyeva M, Shatalova O. Pharmacoeconomic evaluation of treating acute venous thromboembolism with rivaroxaban in the inpatient setting. Meditsinskiy sovet = Medical Council. 2014;(8):18-23. (In Russ.) https://doi.org/10.21518/2079-701X-2014-8-18-23

Views: 542


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2079-701X (Print)
ISSN 2658-5790 (Online)