Economic evaluation of dabigatran etexilate for the primary prevention of venous tromboembolic events following major orthopedic surgery in the Netherlands

Journal of Medical Economics
Maarten J PostmaJacobus R B J Brouwers

Abstract

Dabigatran etexilate is a new oral direct thrombin inhibitor for prophylaxis of venous thromboembolism (VTE) in patients who have elective surgery for total hip replacement (THR) or total knee replacement (TKR). Among the advantages of dabigatran etexilate over subcutaneous prophylaxis with Low Molecular Weight Heparin (LMWH) are reduced resource uses for (i) teaching patients to self-inject; (ii) home-care visits for subcutaneous administration; and (iii) absence of heparin-induced thrombocytopenia (HIT). Based on the demonstrated non-inferiority, the aim of this study was to conduct a cost-minimization analysis of oral dabigatran etexilate vs subcutaneous low-molecular weight heparin (LMWH) and fondaparinux from the Dutch healthcare perspective. A retrospective cohort study was conducted to measure resource use associated with subcutaneous prophylaxis. Results of this study were used in the model to elucidate specific advantages of dabigatran etexilate, next to reduced needs for self-inject teaching and lack of Heparin-Induced Thrombocytopenia. Drug and other resource utilization data were combined with local unit costs. Probabilistic sensitivity analysis was performed to account for uncertainty around relevant parameters inc...Continue Reading

References

Aug 12, 2003·European Journal of Health Law·Geert Jan Hamilton
Mar 9, 2005·Orthopedics·Clifford W ColwellBeverly A Morris
Aug 25, 2006·The New England Journal of Medicine·Gowthami M Arepally, Thomas L Ortel
Jan 16, 2008·Archives of Internal Medicine·Gustavo B F OliveiraUNKNOWN Complications After Thrombocytopenia Caused by Heparin (CATCH) Registry Investigators
Dec 31, 2009·Journal of Thrombosis and Haemostasis : JTH·M C Struijk-MulderH R Büller
May 4, 2010·Thrombosis Research·R J FriedmanUNKNOWN RE-MOBILIZE, RE-MODEL, RE-NOVATE Steering Committees

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