Abstract:
BACKGROUND:Non-vitamin K antagonist oral anticoagulants (NOACs) have been included in international guidelines as important alternatives to vitamin K antagonists (VKAs) for the treatment of venous thromboembolism (VTE) and stroke prevention in non-valvular atrial fibrillation (NVAF). Meanwhile, in the Netherlands, NOACs are widely used next to VKAs. The objective of this study is to estimate the cost-effectiveness of treatment with rivaroxaban compared to VKAs in NVAF and VTE patients in the Netherlands, using data from international prospective observational phase IV studies. METHODS:Two models were developed to represent NVAF and VTE patients, populated with patients from the XANTUS (NCT01606995) and XALIA (NCT01619007) international prospective observational studies. The 1-year cost-effectiveness of rivaroxaban use, compared to VKAs, was explored in a population consisting of NVAF and VTE patients (base case) as well as for four scenarios with sub-populations: NVAF patients only, VTE patients only, NVAF patients with unstable international normalized ratio (INR), and NVAF patients using an INR self-measuring device. RESULTS:In the base case, rivaroxaban saved €72,350 and gained 21 quality-adjusted life-years (QALYs) in a simulation of 2,000 patients over the use of VKAs. Ergo, rivaroxaban was dominant over VKAs. The probabilistic sensitivity analysis showed a probability of 85% for rivaroxaban being dominant and 100% at a willingness-to-pay threshold of €20,000/QALY. Rivaroxaban appeared to be dominant in all scenarios as well, except for the NVAF-patients-only scenario where the incremental cost-effectiveness ratio (ICER) was €157/QALY. CONCLUSIONS:In patients with NVAF or VTE, rivaroxaban treatment is likely to be cost-effective and a potentially cost-saving alternative to VKA in the Netherlands.
journal_name
J Med Econjournal_title
Journal of medical economicsauthors
de Jong LA,Gout-Zwart JJ,van den Bosch M,Koops M,Postma MJdoi
10.1080/13696998.2018.1563404subject
Has Abstractpub_date
2019-04-01 00:00:00pages
306-318issue
4eissn
1369-6998issn
1941-837Xjournal_volume
22pub_type
杂志文章,多中心研究abstract:OBJECTIVE:The aim of this study was to evaluate medication adherence and persistence of patients treated with Etanercept and Adalimumab for Rheumatoid Arthritis, also giving economic evaluations on therapy costs for Received Daily Dose (RDD). MATERIALS AND METHODS:This retrospective study took into account 6 years fro...
journal_title:Journal of medical economics
pub_type: 杂志文章
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journal_title:Journal of medical economics
pub_type: 杂志文章
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journal_title:Journal of medical economics
pub_type: 杂志文章
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journal_title:Journal of medical economics
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journal_title:Journal of medical economics
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journal_title:Journal of medical economics
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Journal of medical economics
pub_type: 杂志文章
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更新日期:2013-09-01 00:00:00
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journal_title:Journal of medical economics
pub_type: 杂志文章,随机对照试验
doi:10.3111/13696998.2013.770747
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journal_title:Journal of medical economics
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journal_title:Journal of medical economics
pub_type: 杂志文章,多中心研究
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