Cost-effectiveness Analysis for Apixaban in the Acute Treatment and Prevention of Venous Thromboembolism in the Netherlands

Jong, Lisa A. de; Dvortsin, Evgeni; Janssen, Kristel J.M.; Postma, Maarten J.

doi:10.1016/j.clinthera.2016.12.012

Cited by 18 publications

(12 citation statements)

References 28 publications

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“…Their advice is based upon the balance of different criteria [71,103]. Other values reported in the literature are 20,000 EUR/QALY [104,105] and 20,000 to 50,000 EUR/QALY [106].…”

Section: Netherlandsmentioning

confidence: 99%

Cost-effectiveness thresholds: methods for setting and examples from around the world

Santos

Guerra

Godman

et al. 2018

Expert Review of Pharmacoeconomics & Outcomes Research

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Cost-effectiveness thresholds (CETs) are used to judge if an intervention represents sufficient value for money to merit adoption in healthcare systems. The study was motivated by the Brazilian context of HTA, where meetings are being conducted to decide on the definition of a threshold. Areas covered: An electronic search was conducted on Medline (via PubMed), Lilacs (via BVS) and ScienceDirect followed by a complementary search of references of included studies, Google Scholar and conference abstracts. Cost-effectiveness thresholds are usually calculated through three different approaches: the willingness-to-pay, representative of welfare economics; the precedent method, based on the value of an already funded technology; and the opportunity cost method, which links the threshold to the volume of health displaced. An explicit threshold has never been formally adopted in most places. Some countries have defined thresholds, with some flexibility to consider other factors. An implicit threshold could be determined by research of funded cases. Expert commentary: CETs have had an important role as a 'bridging concept' between the world of academic research and the 'real world' of healthcare prioritization. The definition of a cost-effectiveness threshold is paramount for the construction of a transparent and efficient Health Technology Assessment system.

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“…Their advice is based upon the balance of different criteria [71,103]. Other values reported in the literature are 20,000 EUR/QALY [104,105] and 20,000 to 50,000 EUR/QALY [106].…”

Section: Netherlandsmentioning

confidence: 99%

Cost-effectiveness thresholds: methods for setting and examples from around the world

Santos

Guerra

Godman

et al. 2018

Expert Review of Pharmacoeconomics & Outcomes Research

View full text Add to dashboard Cite

show abstract

“…The structure of the model was in essence the same as our previously published model used for cost-effectiveness for acute (6 months) treatment of VTE. 10 Supplementary Fig. S1 outlines the structure of the model, in which patients were able to move through 12 different health states.…”

Section: Methodsmentioning

confidence: 99%

“…Probabilities of the initial treatment period, used in scenario 1, can be found in our previous CEA publication on the acute treatment of VTE with apixaban. 10…”

Section: Methodsmentioning

confidence: 99%

“…It was assumed that after an IC bleed, the treatment discontinuation was permanent. 10 18 Discontinuation due to non-IC MB and CRNMB was assumed to be 14 and 2 days, respectively. These are the same assumptions as made in the previously published article on apixaban in VTE patients.…”

Section: Methodsmentioning

confidence: 99%

“…The aim of the study was to explore the clinical and economic consequences of extended treatment with apixaban versus no extended treatment in the Netherlands, based on an updated and adapted, previously published cost-effectiveness model of apixaban in VTE patients. 10…”

Section: Introductionmentioning

confidence: 99%

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Extended Treatment with Apixaban for Venous Thromboembolism Prevention in the Netherlands: Clinical and Economic Effects

Jong

Gout-Zwart

Stevanović

et al. 2018

TH Open

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Background Dutch guidelines advise extended anticoagulant treatment with direct oral anticoagulants or vitamin K antagonists for patients with idiopathic venous thromboembolism (VTE) who do not have high bleeding risk. Objectives The aim of this study was to analyze the economic effects of extended treatment of apixaban in the Netherlands, based on an updated and adapted previously published model. Methods We performed a cost-effectiveness analysis simulating a population of 1,000 VTE patients. The base-case analysis compared extended apixaban treatment to no treatment after the first 6 months. Five additional scenarios were conducted to evaluate the effect of different bleeding risks and health care payers' perspective. The primary outcome of the model is the incremental cost-effectiveness ratio (ICER) in costs (€) per quality-adjusted life-year (QALY), with one QALY defined as 1 year in perfect health. To account for any influence of the uncertainties in the model, probabilistic and univariate sensitivity analyses were conducted. The treatment was considered cost-effective with an ICER less than €20,000/QALY, which is the most commonly used willingness-to-pay (WTP) threshold for preventive drugs in the Netherlands. Results The model showed a reduction in recurrent VTE and no increase in major bleeding events for extended treatment in all scenarios. The base-case analysis showed an ICER of €9,653/QALY. The probability of being cost-effective for apixaban in the base-case was 70.0% and 91.4% at a WTP threshold of €20,000/QALY and €50,000/QALY, respectively. Conclusion Extended treatment with apixaban is cost-effective for the prevention of recurrent VTE in Dutch patients.

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Cost-Effectiveness of Aspirin for Extended Venous Thromboembolism Prophylaxis After Major Surgery for Inflammatory Bowel Disease

Leeds

Sklow

Görgün

et al. 2022

Journal of Gastrointestinal Surgery

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Cost-effectiveness Analysis for Apixaban in the Acute Treatment and Prevention of Venous Thromboembolism in the Netherlands

Cited by 18 publications

References 28 publications

Cost-effectiveness thresholds: methods for setting and examples from around the world

Cost-effectiveness thresholds: methods for setting and examples from around the world

Extended Treatment with Apixaban for Venous Thromboembolism Prevention in the Netherlands: Clinical and Economic Effects

Cost-Effectiveness of Aspirin for Extended Venous Thromboembolism Prophylaxis After Major Surgery for Inflammatory Bowel Disease

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