Cost-effectiveness of fondaparinux compared with enoxaparin as prophylaxis against venous thromboembolism in patients undergoing hip fracture surgery

Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Sean D SullivanEdith Nutescu

Abstract

To evaluate the cost-effectiveness of fondaparinux relative to enoxaparin as prophylaxis against venous thromboembolism (VTE) in patients undergoing hip fracture surgery. A decision analysis model was created to simulate the impact of fondaparinux 2.5 mg once daily relative to enoxaparin 30 mg twice daily on patient outcomes and costs over various time points up to 5 years after surgery. Probabilities for the analysis were estimated for a hypothetical cohort of 1000 patients undergoing hip fracture surgery in the United States receiving either fondaparinux or enoxaparin according to comparative trial results. Resource use and costs (2003 dollars) were obtained from large health-care databases. Outcome measures were rates of symptomatic VTE events, health-care costs, and incremental cost-effectiveness ratios. Fondaparinux is estimated to prevent an additional 30 VTE events (per 1000 patients) at 3 months compared with enoxaparin, producing savings of 103 dollars at discharge, 290 dollars over 1 month, 361 dollars over 3 months, and 466 dollars over 5 years. The results remain robust to clinically plausible variation in input parameters and assumptions. Fondaparinux improves outcomes and is cost-saving over a broad range of assum...Continue Reading

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Citations

Nov 26, 2010·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·D MarslandS L Kates
Oct 1, 2011·Expert Review of Pharmacoeconomics & Outcomes Research·Lars RyttbergIngela Björholt
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