Cost-effectiveness of edoxaban vs low-molecular-weight heparin and warfarin for cancer-associated thrombosis in Brazil

Lopes, Danilo G.; Tamayo, Arturo; Schipp, Bernhard; Siepmann, Timo

doi:10.1016/j.thromres.2020.08.014

Cited by 9 publications

(16 citation statements)

References 27 publications

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“…However, only one study from a US payer perspective was found that compared the cost-effectiveness of different NOACs (Edoxaban + Rivaroxaban) compared with LMWHs[26], have demonstrated NOACs were costsaving options. The other previous study in the Brazilian population showed that edoxaban is a cost-saving alternative to LMWH for the management of CAT with incremental cost and QALY increases were $ 16,654.27 and 3.2, respectively [24].…”

Section: Discussionmentioning

confidence: 76%

“…Several cost-effectiveness analyses have been conducted in different countries [24,25], but none of them evaluated all NOACs simultaneously, with majority of them focusing on single NOACs only. However, only one study from a US payer perspective was found that compared the cost-effectiveness of different NOACs (Edoxaban + Rivaroxaban) compared with LMWHs[26], have demonstrated NOACs were costsaving options.…”

Section: Discussionmentioning

confidence: 99%

“…We constructed a Markov model using proprietary software (TreeAge Pro 2011 Software, Williamstown, MA) concerning a hypothetical reference case, which was similar to the approach adopted in previously published studies [24,[26][27][28][29]. A hypothetical cancer population of 64-year-old, 70 kg, and with VTE event receiving treatment with NOACs or LMWHs was considered for the model.…”

Section: Overview Of the Modelmentioning

confidence: 99%

“…However, the use of these new oral anticoagulants should be carefully considered in the decision-making process by balancing the clinical bene ts and the related costs. Earlier studies found that the cost-effectiveness results for NOACs were uneven in different countries as compared with those for LMWHs [24][25][26][27], re ecting that costeffectiveness may depend heavily on country-speci c health system organizations and economics.…”

mentioning

confidence: 99%

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New Oral Anticoagulants Versus Low Molecular Weight Heparins for the Treatment of Cancer-associated Thrombosis: a Cost-effectiveness Analysis

Wumaier

Chen

et al. 2021

Preprint

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Background: Recently, new oral anticoagulants (NOACs) have been included in guidelines for the treatment of cancer-associated thrombosis (CAT) to be extended to suitable cancer patients. The purpose of this study was to compare the cost-effectiveness of using NOACs and low molecular weight heparins(LMWHs) for treating CAT from the perspective of the Chinese healthcare system. Methods: A Markov model was constructed to estimate the cost-effectiveness of the two strategies with a 6-month and 5-year time horizon. Input parameters were either sourced from the clinical trial, published literature. The primary outcome of the model was reported as incremental cost-effectiveness ratios (ICERs). Sensitivity analyses were performed to test model uncertainty. Results: The 6-month cost of NOACs was $ 654.65 with 0.40 QALYs while the 6-month cost of LMWHs was $ 1719.31 with 0.37 QALYs. Similarly, treatment with NOACs had a lower cost ($ 657.85 vs. $ 1716.56) and more health benefits (0.40 QALY vs. 0.37 QALY) than treatment with LMWHs in a subgroup of patients with gastrointestinal malignancy. We found treatment with NOACs would result in a large reduction in cost($ 1447.22 vs. $ 3374.70) but a small reduction in QALYs (3.07 QALY vs. 3.09 QALY) compared with LMWHs over a 5-year time frame, resulting in an ICER of $ 112895.50/QALY. Sensitivity analysis confirmed the robustness of the results. Conclusion: As compared to LMWHs, NOACs can be a cost-saving anticoagulant choice for the treatment of CAT in the general oncology population and gastrointestinal malignancy population.Classification codes: I.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Overview Of the Modelmentioning

confidence: 99%

mentioning

confidence: 99%

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New Oral Anticoagulants Versus Low Molecular Weight Heparins for the Treatment of Cancer-associated Thrombosis: a Cost-effectiveness Analysis

Wumaier

Chen

et al. 2021

Preprint

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“…However, the use of these new oral anticoagulants should be carefully considered in the decision-making process by balancing the clinical benefits and the related costs. Earlier studies found that the cost-effectiveness results for DOACs were uneven in different countries as compared with those for LMWHs [ 24 – 27 ], reflecting that cost-effectiveness may depend heavily on country-specific health system organizations and economics.…”

Section: Introductionmentioning

confidence: 99%

Direct oral anticoagulants versus low molecular weight heparins for the treatment of cancer-associated thrombosis: a cost-effectiveness analysis

Wumaier

Chen

et al. 2021

Thrombosis J

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Background Recently, direct oral anticoagulants (DOACs) have been included in guidelines for the treatment of cancer-associated thrombosis (CAT) to be extended to suitable cancer patients. The purpose of this study was to compare the cost-effectiveness of using DOACs and low molecular weight heparins (LMWHs) for treating CAT from the perspective of the Chinese healthcare system. Methods A Markov model was constructed to estimate the cost-effectiveness of the two strategies with a 6-month and 5-year time horizon. Input parameters were either sourced from the clinical trial, published literature. The primary outcome of the model was reported as incremental cost-effectiveness ratios (ICERs). Sensitivity analyses were performed to test model uncertainty. Results The 6-month cost of DOACs was $ 654.65 with 0.40 quality adjusted life-years (QALYs) while the 6-month cost of LMWHs was $USD 1719.31 with 0.37 QALYs. Similarly, treatment with DOACs had a lower cost ($USD 657.85 vs. $USD 1716.56) and more health benefits (0.40 QALYs vs. 0.37 QALYs) than treatment with LMWHs in a subgroup of patients with gastrointestinal malignancy. We found treatment with DOACs would result in a large reduction in cost ($USD 1447.22 vs. $USD 3374.70) but a small reduction in QALYs (3.07 QALYs vs. 3.09 QALYs) compared with LMWHs over a 5-year time frame, resulting in an ICER of $USD 112895.50/QALYs. Sensitivity analysis confirmed the robustness of the results. Conclusion As compared to LMWHs, DOACs can be a cost-saving anticoagulant choice for the treatment of CAT in the general oncology population and gastrointestinal malignancy population.

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Treatment and secondary prophylaxis of venous thromboembolism in cancer patients

Ali

Young

2022

Support Care Cancer

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Cost-effectiveness of edoxaban vs low-molecular-weight heparin and warfarin for cancer-associated thrombosis in Brazil

Cited by 9 publications

References 27 publications

New Oral Anticoagulants Versus Low Molecular Weight Heparins for the Treatment of Cancer-associated Thrombosis: a Cost-effectiveness Analysis

New Oral Anticoagulants Versus Low Molecular Weight Heparins for the Treatment of Cancer-associated Thrombosis: a Cost-effectiveness Analysis

Direct oral anticoagulants versus low molecular weight heparins for the treatment of cancer-associated thrombosis: a cost-effectiveness analysis

Treatment and secondary prophylaxis of venous thromboembolism in cancer patients

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