Cost-Effectiveness of Enoxaparin as Thromboprophylaxis in Acutely Ill Medical Patients in Spain

Nuijten, Mark; Antoñanzas, Fernando; Kosa, J; Nadipelli, Vijay; Rubio-Terrés, C.; Suárez, Carmen

doi:10.1046/j.1524-4733.2003.00210.x

Cited by 24 publications

(19 citation statements)

References 16 publications

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“…In France, the cost of drugs was obtained from the Banque Claude Bernard database (Banque Claude Bernard, Group Cegedim, Boulogne Billancourt, France, 2007) The assessment for Italy used information on the cost of treating adverse events from the report of a Delphi panel of experts from five clinical practices (Capri et al, 2007), from the Italian national DRG tariff (Conferenza delle Regioni e Province Autonome) and data from studies by Nuijten et al (2002) and Jansen et al (1997).…”

Section: Methodsmentioning

confidence: 99%

Costs of managing adverse events in the treatment of first-line metastatic renal cell carcinoma: bevacizumab in combination with interferon-α2a compared with sunitinib

et al. 2009

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BACKGROUND: Bevacizumab plus interferon-a2a (IFN) prolongs progression-free survival to 410 months, which is comparable with sunitinib as first-line treatment of metastatic renal cell carcinoma (RCC). The two regimens have different tolerability profiles; therefore, costs for managing adverse events may be an important factor in selecting therapy. METHODS: Costs of managing adverse events affecting patients with metastatic RCC eligible for treatment with bevacizumab plus IFN or sunitinib were evaluated using a linear decision analytical model. Management costs were calculated from the published incidence of adverse events and health-care costs for treating adverse events in the United Kingdom, Germany, France and Italy. RESULTS: Adverse event management costs were higher for sunitinib than for bevacizumab plus IFN. The average cost per patient for the management of grade 3 -4 adverse events was markedly lower with bevacizumab plus IFN compared with sunitinib in the United Kingdom (h1475 vs h804), Germany (h1785 vs h1367), France (h2590 vs h1618) and Italy (h891 vs h402). The main cost drivers were lymphopaenia, neutropaenia, thrombocytopaenia, leucopaenia and fatigue/asthaenia for sunitinib; and proteinuria, fatigue/ asthaenia, bleeding, anaemia and gastrointestinal perforation for bevacizumab plus IFN. CONCLUSION: The costs of managing adverse events are lower for bevacizumab plus IFN than for sunitinib. The potential for cost savings should be considered when selecting treatments for RCC.

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Section: Methodsmentioning

confidence: 99%

Costs of managing adverse events in the treatment of first-line metastatic renal cell carcinoma: bevacizumab in combination with interferon-α2a compared with sunitinib

et al. 2009

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“…Two studies that reported incremental costs of $65 to $2,534 per quality-adjusted life-year gained over no prophylaxis were both sponsored by the pharmaceutical industry. 33,34 In populations at sufficiently high risk ( Tables 2, 6 , Table S7), pharmacoprophylaxis is likely to be favorable from a resource standpoint for preventing VTE. 35,36 The comparison between different types of prophylaxis, however, is less clear.…”

Section: Anticoagulant Thromboprophylaxis In Acutely Ill Hospitalizedmentioning

confidence: 99%

Prevention of VTE in Nonsurgical Patients

Falck‐Ytter

Francis

Johanson

et al. 2012

Chest

1,768

485

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“…The studies reviewed herein are summarized in Table 2. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Some critical methodological considerations are briefly described below.…”

Section: Methodological Considerationsmentioning

confidence: 99%

“…De Lissovoy and Subedi 15 considered the data from the perspective of a third-party payer, calculating the use of enoxaparin would cost between $1249 and $3088 per VTE episode avoided. Similarly, Nuijten et al 16 assessed the cost-effectiveness of this same intervention from the perspective of the Italian National Health Service. Using a different analytic approach, they calculated that the cost per VTE event avoided was €2451, whereas that per life saved was €8396, both in comparison with no treatment.…”

Section: Medical Patientsmentioning

confidence: 99%

Comparing the Costs, Risks, and Benefits of Competing Strategies for the Primary Prevention of Venous Thromboembolism

Avorn

Winkelmayer

2004

Circulation

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Abstract-Systematic cost-effectiveness analyses of regimens used for preventing venous thromboembolism (VTE) are becoming increasingly important for several reasons: the aging of the population, with an accompanying increase in admissions for orthopedic procedures or other surgery; expanded indications for thromboprophylaxis in nonsurgical patients; and the introduction of more expensive new agents that may increase safety and efficacy. At the same time, health care systems are under unprecedented pressure to contain the costs of care, particularly medications. Such economic analyses are made more difficult by the paucity of clinical trials comparing treatment regimens to one another rather than to placebo. Several methodological issues must be kept in mind when evaluating cost-effectiveness analyses of VTE prophylaxis. These include the perspective from which the analysis is performed (eg, the health care system as a whole versus a particular payer), limitations of trial data (eg, artificially short time horizons), and definition of outcomes (eg, flawed definition and grouping together of adverse effects or treatment failures). Quantifying costs across nations and health care systems is problematic as well. Another challenge is the extrapolation of efficacy data from highly monitored study patients to routine practice settings. Nevertheless, cost-effectiveness analyses of VTE treatments conducted in orthopedic surgery, trauma, general surgery, and acute medical settings can help define the relationships among expenditures, adverse outcomes, and patient benefit for particular therapeutic strategies in a variety of clinical situations. Key Words: venous thromboembolism Ⅲ cost-effectiveness Ⅲ prophylaxis Ⅲ low-molecular-weight heparin Ⅲ low-dose unfractionated heparin Ⅲ warfarin I n recent years, several factors have emerged that increase the importance of economic assessment of regimens used for the primary prevention of venous thromboembolism (VTE). For many decades, unfractionated heparin (UFH) and warfarin were the mainstays of treatment in this clinical setting. However, beginning in the 1990s and continuing to the present, new agents appeared that held the promise of greater efficacy and/or safety, albeit at greater financial cost. Moreover, new clinical and epidemiologic information emerged that stressed the importance of prophylaxis for VTE in a growing number of common clinical situations. These developments have occurred at the same time that health care systems throughout the world face unprecedented pressures to contain the costs of care. This has been particularly true for medications, which represent the fastest growing component of health care costs, rising between 13% and 19% annually in recent years. 1 Measuring the cost-effectiveness of medical interventions is a relatively new field; its methodologies are still evolving and are, on occasion, controversial. Nevertheless, consensus has developed over the appropriate broad approach to this discipline: given that an adequate evidence base of data fr...

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Cost-Effectiveness of Enoxaparin as Thromboprophylaxis in Acutely Ill Medical Patients in Spain

Cited by 24 publications

References 16 publications

Costs of managing adverse events in the treatment of first-line metastatic renal cell carcinoma: bevacizumab in combination with interferon-α2a compared with sunitinib

Costs of managing adverse events in the treatment of first-line metastatic renal cell carcinoma: bevacizumab in combination with interferon-α2a compared with sunitinib

Prevention of VTE in Nonsurgical Patients

Comparing the Costs, Risks, and Benefits of Competing Strategies for the Primary Prevention of Venous Thromboembolism

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